Acute Idiopathic Scrotal Edema

We report a case of acute idiopathic scrotal edema (AISE) in a 4-year-old boy who presented with acute scrotal pain and erythema. The clinical features, ultrasound appearance, and natural history of this rare diagnosis are reviewed. In this report, we highlight the importance of good ultrasound technique in differentiating the etiology of the acute scrotum and demonstrate the color Doppler “Fountain Sign” that is highly suggestive of AISE.

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Ultrasonographic findings of epididymal torsion in adults - a rare cause of acute scrotum

Medicinski pregled ◽

10.2298/mpns2102038d ◽

2021 ◽

Vol 74 (1-2) ◽

pp. 38-40

Author(s):

Daniela Donat ◽

Slobodan Torbica ◽

Sandra Trivunic-Dajko ◽

Viktor Till

Keyword(s):

Differential Diagnosis ◽

Ultrasound Examination ◽

Color Doppler ◽

The Body ◽

Acute Scrotum ◽

Heterogeneous Structure ◽

Scrotal Pain ◽

Acute Scrotal Pain ◽

Whirlpool Sign ◽

Head Area

Introduction. Epididymal torsion is a rare cause of acute scrotum. Only a few cases have been described in the literature, and preoperative ultrasound diagnosis was done only in two cases. So far, according to our data, cases of epididymal torsion in adults have not previously been reported in the literature. Case Report. We report the case of a 39-year-old man, who was admitted to the hospital for pain in the left hemiscrotum lasting for three days. The physical examination revealed a swelling limited to the left hemiscrotum, so the patient was referred for an ultrasound examination with the diagnosis of epididymitis. The ultrasonography showed that the left epididymis was significantly enlarged in the head area with and heterogeneous structure of the parenchyma on a grayscale, without a significant Color Doppler signal. At the level of the neck and the body of the epididymis, there was a ?whirlpool sign? with a reactive hydrocele and edema of the left scrotum soft tissue that was highly suspicious for torsion of the epididymis. The patient underwent emergency surgery and epididymal torsion of about 540 degrees was confirmed intraoperatively. Conclusion. The torsion of the epididymis should be kept in mind in the differential diagnosis of acute scrotal pain in adults.

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Unusual Cause of Acute Scrotal Pain-Inflammatory Noncommunicating Hydrocele: A Pediatric Case Report

Case Reports in Medicine ◽

10.1155/2018/2862514 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Yoshinobu Moritoki ◽

Kentaro Mizuno ◽

Taiki Kato ◽

Takahiro Yasui ◽

Yutaro Hayashi

Keyword(s):

Differential Diagnosis ◽

Emergency Surgery ◽

Doppler Ultrasonography ◽

Color Doppler ◽

Color Doppler Ultrasonography ◽

Acute Scrotum ◽

Pediatric Case ◽

Scrotal Pain ◽

Acute Scrotal Pain ◽

General Physicians

The etiology of scrotal pain is clinically classified in terms of the necessity for emergency surgery. Lately, color Doppler ultrasonography has reduced unnecessary surgeries, but there are still some cases that require immediate exploration because of an uncertain diagnosis. Here, we describe the case of a 14-month-old boy, who could not deliver his complaint accurately, presenting with a grumpy mood and a red swollen scrotum. Emergency surgery revealed that the cause was intense inflammation of the hydrocele wall, which typically does not cause acute scrotum. We also reviewed rare etiologies of scrotal pain for general physicians to develop the differential diagnosis.

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Color Doppler Echocardiographic Study on the Incidence and Natural History of Early-Infancy Muscular Ventricular Septal Defect

Pediatrics & Neonatology ◽

10.1016/j.pedneo.2011.06.003 ◽

2011 ◽

Vol 52 (5) ◽

pp. 256-260 ◽

Cited By ~ 13

Author(s):

Jia-Kan Chang ◽

Wen-Yen Jien ◽

Hui-Lan Chen ◽

Kai-Sheng Hsieh

Keyword(s):

Natural History ◽

Ventricular Septal Defect ◽

Septal Defect ◽

Color Doppler ◽

Early Infancy ◽

Muscular Ventricular Septal Defect ◽

Echocardiographic Study ◽

History Of

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Ultrasonological evaluation of acute scrotum

Nepalese Journal of Radiology ◽

10.3126/njr.v6i1-2.19207 ◽

2018 ◽

Vol 6 (1-2) ◽

pp. 11-14

Author(s):

Prakash Sharma ◽

Merina Gyawali ◽

Sristi Singh

Keyword(s):

Statistical Analysis ◽

Color Doppler ◽

Descriptive Analysis ◽

Power Doppler ◽

Rank Correlation ◽

Final Diagnosis ◽

Acute Scrotum ◽

Age Group ◽

Scrotal Pain ◽

Kendall Rank Correlation

Introduction: Acute scrotum is a common surgical condition. Ultrasound along with Doppler plays an important role in differentiating the various causes. Purpose of this study was to evaluate the role of ultrasound in identifying the various causes of acute scrotum.Methods: All patients with history of acute scrotum presenting to the Department of Radiology were included in the study. Scrotal ultrasound was performed with a linear 7.5 to 12-MHz transducer with abundant acoustic gel. Imaging was done in longitudinal and transverse planes with Power Doppler and Color Doppler. The testes, epididymis, spermatic cord, scrotal wall and inguinal region were evaluated. Kidney, Ureter and Bladder region was evaluated for possibility of calculus. Final diagnosis was made based on clinical outcome, follow up, intraoperative findings and histopathology when available. Statistical analysis was done using SPSS version 18 for windows. Descriptive analysis was done. Non parametric correlation between side and torsion was done using Kendall Rank Correlation Coefficient.Results: There were altogether 50 patients available for statistical analysis. Age of the patients ranged from 14 to 65 years with mean age of 34.7±14.7 years. Most common age group was 21 to 40 years. Inflammatory pathology was the most common pathology of actual scrotal pain. There was no significant correlation between side of pain and testicular torsion.Conclusion: Inflammatory pathology was the most common cause for actual scrotal pain. The most common age group was 21 to 40 years.

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Clinical Features and Natural History of Patients Diagnosed With Asymptomatic Ulcerative Colitis

Inflammatory Bowel Diseases ◽

10.1097/00054725-201212001-00079 ◽

2012 ◽

Vol 18 ◽

pp. S33-S34

Author(s):

Soo-Kyung Park ◽

Byong Duk Ye ◽

Suk-Kyun Yang ◽

Jong Wook Kim ◽

Sang Hyoung Park ◽

...

Keyword(s):

Ulcerative Colitis ◽

Natural History ◽

Clinical Features ◽

History Of

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Clinical features and natural history of clinically non-functioning pituitary incidentalomas

Endocrine Abstracts ◽

10.1530/endoabs.49.ep891 ◽

2017 ◽

Author(s):

Pedro Iglesias ◽

Karina Arcano ◽

Vanessa Trivino ◽

Paula Garcia-Sancho ◽

Juan Jose Diez ◽

...

Keyword(s):

Natural History ◽

Clinical Features ◽

History Of

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Fountain’s Sign as a Diagnostic Key in Acute Idiopathic Scrotal Edema: Case Report and Review of the Literature

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2018.22 ◽

2018 ◽

Vol 61 (1) ◽

pp. 37-39 ◽

Cited By ~ 3

Author(s):

Dimitrios Patoulias ◽

Vasileios Rafailidis ◽

Thomas Feidantsis ◽

Maria Kalogirou ◽

Dimitrios Rafailidis ◽

...

Keyword(s):

Physical Examination ◽

Color Doppler ◽

Unknown Etiology ◽

Acute Scrotum ◽

Conservative Strategy ◽

Ultrasonographic Examination ◽

Arterial Blood ◽

Scrotal Edema ◽

Diagnostic Key ◽

The Right

The acute idiopathic scrotal edema (AISE) is a self-limited disease of unknown etiology, characterized by edema and erythema of the scrotum and the dartos, without expansion to the underlying layers of scrotum’s wall or to the endoscrotal structures. Boys younger than 10 years old are usually involved in 60–90% of all cases. Diagnosis is made after exclusion of other causes of acute scrotum. We present a case of a 7-year old boy, who was admitted to the Emergency Department due to development of scrotal edema and erythema over the last 48 hours, which extended to the base of the penis. The patient mentioned that he first noticed the erythema on the anterior surface of the right hemiscrotum, which gradually extended. Physical examination did not reveal presence of pathology involving the endoscrotal structures, indicative of need for urgent surgical intervention. Transillumination was negative for blue dot sign. Ultrasonographic examination of the scrotum documented the homogeneity of the testicular parenchyma, while color Doppler revealed the presence of fountain’s sign (equal arterial blood supply to both testicles). Conservative strategy was followed and the patient gradually improved within the next three days. In conclusion, meticulous physical examination along with ultrasonographic examination of the suffering scrotum, especially with the highlighting of fountain’s sign with color Doppler, document the diagnosis of AISE. Thus, need for urgent surgical investigation of the suffering scrotum due to diagnostic doubt is limited.

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