HistoryThis section has been translated automatically.
DefinitionThis section has been translated automatically.
Acute idiopathic scrotal edema is a non-febrile, possibly painful or pruritic (Braun MM et al. 2013), unilateral (33% of cases)-or bilateral (66% of cases) edematous swelling of the scrotal skin and tunica dartos (Patoulias D et al. 2018), which just reaches the perineum or groin. An accompanying erythema which is clearly hyperesthetic when stroking sharply delimits the findings from the surrounding area. Palpatorily no additional abnormalities of the scrotal content and no palpable laboratory changes can be detected. Enlarged inguinal lymph nodes are described.
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EtiopathogenesisThis section has been translated automatically.
The etiology is unclear; a possible allergic reaction is discussed. An atopic diathesis is usually not detectable (Santi M et al.2018). The disease has been described several times in the context of a purpura Schönlein-Henoch. Lee SH et al. described the edema in the context of an Epstein-Barr infection.
ManifestationThis section has been translated automatically.
Children before puberty; in a larger review study (n=311), age ranged from 5- 8 years (Santi M et al. 2018). Less frequently in adulthood.
ImagingThis section has been translated automatically.
Using ultrasound, the isolated thickening of the skin on the affected side can be documented. Its increased perfusion can be documented by colour Doppler examination (so-called Fountain-sign). Abnormalities of the testicles and epididymis should be excluded.
LaboratoryThis section has been translated automatically.
Possible eosinophilia in the blood count.
Differential diagnosisThis section has been translated automatically.
- Testicular torsion: characteristic clinical findings; Doppler sonographic findings
- Hydatident torsion characteristic clinical findings; Doppler sonographic findings;
- clinical findings characteristic of epididymitis; Doppler sonography findings;
- hernia or hydrocele characteristic clinical findings; Doppler sonography findings;
- Bacterial infections (e.g. erysipelas, scrotal phlegmons).
TherapyThis section has been translated automatically.
If necessary, bed rest and analgesics are recommended.
Progression/forecastThis section has been translated automatically.
The disease is self-limiting and subsides within 2-3 days even without special therapy. Recurrences are possible (about 10% of cases).
LiteratureThis section has been translated automatically.
- Baruch K et al (2002) Acute idiopathic scrotal edema in children - revisited. J Ped Surg 37: 1200-1202
- Braun MM et al (2013) A case report of acute idiopathic scrotal edema. Mil Med 178: e890-2.
- Lee SH et al (2016) Acute Idiopathic Scrotal Edema Caused by Epstein-Barr Virus. Pediatric Infect Dis J 35:593.
- Patoulias D et al (2018) Fountain's Sign as a Diagnostic Key in Acute Idiopathic Scrotal Edema: Case Report and Review of the Literature. Acta Medica (Hradec Kralove) 61:37-39.
- Qvist O (1956) Swelling of the scrotum in infants and children, and nonspecific epididymitis. A study of 158 cases. Acta Chir Scand 110:417-421
- Santi M et al (2018) Acute Idiopathic Scrotal Edema: Systematic Literature Review. Eur J Pediatrics Surgery 28:222-226.
- Schröder A (2017) Idiopathic scrotal edema - a differential diagnosis of the acute scrotum. Actuel Urol 48: 54-56
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