Acute Idiopathic Scrotal Edema: Systematic Literature Review

Maristella Santi; Sebastiano A. G. Lava; Giacomo D. Simonetti; Mario G. Bianchetti; Gregorio P. Milani

doi:10.1055/s-0037-1603089

European Journal of Pediatric Surgery, Table of Contents

Eur J Pediatr Surg 2018; 28(03): 222-226
DOI: 10.1055/s-0037-1603089

Review Article

Georg Thieme Verlag KG Stuttgart · New York

Acute Idiopathic Scrotal Edema: Systematic Literature Review

Authors

Maristella Santi

¹Department of Pediatrics, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Switzerland
Sebastiano A. G. Lava

²Department of Pediatrics, University Children's Hospital of Bern, and University of Bern, Bern, Switzerland
Giacomo D. Simonetti

¹Department of Pediatrics, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Switzerland
Mario G. Bianchetti

¹Department of Pediatrics, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Switzerland
Gregorio P. Milani

³Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy

Abstract

Introduction Existing information on acute idiopathic scrotal edema relies on small case series and textbooks.

Methods We searched reports with no date limits on acute idiopathic scrotal edema.

Results Thirty-seven studies were included. Sixteen case series addressed the prevalence of acute idiopathic scrotal edema among males with acute scrotum: among 3,403 cases, the diagnosis of acute idiopathic scrotal edema was made in 413 cases (12%). Twenty-four reports addressed history, findings, management, and course of acute idiopathic scrotal edema in 311 patients. The patients mostly ranged in age from 5 to 8 years, presented with acute scrotal redness and swelling, associated or not with mild pain. Ninety percent or more of the cases developed in patients without atopic diathesis and were not preceded by inguinoscrotal surgery, acute febrile illnesses, or trauma. They were afebrile; in good general condition; and presented without pruritus, nausea or vomiting, or abdominal pain. The lesions were bilateral in two-thirds and unilateral in one-third of the cases. The condition resolved spontaneously within 2 to 3 days without sequelae. Approximately 10% of the cases experienced a recurrence.

Conclusion Acute idiopathic scrotal edema is a self-limiting condition that accounts for ≥ 10% of cases of acute scrotum in children and adolescents.

Keywords

acute scrotum - acute idiopathic scrotal edema - scrotal redness and swelling - imaging studies

Full Text

References

References
1 Qvist O. Swelling of the scrotum in infants and children, and non-specific epididymitis; a study of 158 cases. Acta Chir Scand 1956; 110 (05) 417-421
2 Davenport M. ABC of general surgery in children. Acute problems of the scrotum. BMJ 1996; 312 (7028): 435-437
3 Moher D, Liberati A, Tetzlaff J, Altman DG. ; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009; 151 (04) 264-269
4 Abbate B, Danti DA, Niccoli F, Pampaloni A. Acute scrotum in childhood: considerations on 457 cases [in Spanish]. Pediatr Med Chir 1993; 15 (01) 75-77
5 Abul F, Al-Sayer H, Arun N. The acute scrotum: a review of 40 cases. Med Princ Pract 2005; 14 (03) 177-181
6 Anderson PAM, Giacomantonio JM. The acutely painful scrotum in children: review of 113 consecutive cases. Can Med Assoc J 1985; 132 (10) 1153-1155
7 Boettcher M, Bergholz R, Krebs TF. , et al. Differentiation of epididymitis and appendix testis torsion by clinical and ultrasound signs in children. Urology 2013; 82 (04) 899-904
8 Corbett HJ, Simpson ET. Management of the acute scrotum in children. ANZ J Surg 2002; 72 (03) 226-228
9 Khaleghnejad-Tabari A, Mirshermirani A, Rouzrokh M. , et al. Early exploration in the management of acute scrotum in children. Iran J Pediatr 2010; 20 (04) 466-470
10 Klin B, Zlotkevich L, Horne T, Efrati Y, Serour F, Lotan G. Epididymitis in childhood: a clinical retrospective study over 5 years. Isr Med Assoc J 2001; 3 (11) 833-835
11 Mushtaq I, Fung M, Glasson MJ. Retrospective review of paediatric patients with acute scrotum. ANZ J Surg 2003; 73 (1-2): 55-58
12 Nour S, MacKinnon AE. Acute scrotal swelling in children. J R Coll Surg Edinb 1991; 36 (06) 392-394
13 Sachwitz D, Haß HJ, Kroker S, Meyer F, Krause H. Acute scrotum in childhood [in German]. Zentralbl Chir 2014; 139 (06) 621-626
14 Sakellaris GS, Charissis GC. Acute epididymitis in Greek children: a 3-year retrospective study. Eur J Pediatr 2008; 167 (07) 765-769
15 Brereton RJ, Manley S. Acute scrotal pathology in boys. Z Kinderchir Grenzgeb 1980; 29 (04) 343-347
16 Halb C, Eschard C, Lefebvre F, Brunel D, Abély M, Bernard P. Acute idiopathic scrotal oedema in young boys: a report of ten cases and a review of the literature [in French]. Ann Dermatol Venereol 2010; 137 (12) 775-781
17 Knight PJ, Vassy LE. The diagnosis and treatment of the acute scrotum in children and adolescents. Ann Surg 1984; 200 (05) 664-673
18 Valla JS, Sarkissian J, Mollard P. Acute idiopathic scrotal edema in young boy. A report of 16 cases (author's transl) [in French]. J Chir (Paris) 1981; 118 (02) 101-103
19 Borsa C, Caimi A, Colombo B, Valli F. Acute idiopathic scrotal oedema. Case report [in Italian]. Pediatr Med Chir 1982; 4 (04) 439-442
20 Braun MM, Cronin AJ, Bell DG. A case report of acute idiopathic scrotal edema. Mil Med 2013; 178 (07) e890-e892
21 Breen M, Murphy K, Chow J, Kiely E, O'Regan K. Acute idiopathic scrotal edema. Case Rep Urol 2013; 2013: 829345
22 Copertino M, Benelli E, Gregori M, Barbi E, Ventura A. A shining scrotal fountain. J Pediatr 2015; 167 (01) 205.e1
23 Corazza M, Pizzigoni S, Sprocati M, Virgili A. Acute idiopathic scrotal edema in children. Dermatology 2003; 206 (04) 343-344
24 Erez I, Zifman E, Nersesjanz I, Lazar L, Bucklan G, Gutermacher M. Is there a connection between paediatric acute idiopathic scrotal oedema and intestinal worm infestation?. J Paediatr Child Health 2012; 48 (01) 26-29
25 Evans JP, Snyder HM. Idiopathic scrotal edema. Urology 1977; 9 (05) 549-551
26 Geiger J, Epelman M, Darge K. The fountain sign: a novel color Doppler sonographic finding for the diagnosis of acute idiopathic scrotal edema. J Ultrasound Med 2010; 29 (08) 1233-1237
27 Hanstead B, John HT. Idiopathic scrotal oedema of children. Br J Urol 1964; 36: 110-112
28 Herman TE, Shackelford GD, McAlister WH. Acute idiopathic scrotal edema: role of scrotal sonography. J Ultrasound Med 1994; 13 (01) 53-55
29 Kaplan GW. Acute idiopathic scrotal edema. J Pediatr Surg 1977; 12 (05) 647-649
30 Klin B, Lotan G, Efrati Y, Zlotkevich L, Strauss S. Acute idiopathic scrotal edema in children—revisited. J Pediatr Surg 2002; 37 (08) 1200-1202
31 Lee A, Park SJ, Lee HK, Hong HS, Lee BH, Kim DH. Acute idiopathic scrotal edema: ultrasonographic findings at an emergency unit. Eur Radiol 2009; 19 (08) 2075-2080
32 Lee SH, Lee DG, Yoo KH, Choi SK, Min GE, Lee HL. Acute idiopathic scrotal edema caused by Epstein-Barr virus. Pediatr Infect Dis J 2016; 35 (05) 593
33 Melekos MD, Asbach HW, Markou SA. Etiology of acute scrotum in 100 boys with regard to age distribution. J Urol 1988; 139 (05) 1023-1025
34 Najmaldin A, Burge DM. Acute idiopathic scrotal oedema: incidence, manifestations and aetiology. Br J Surg 1987; 74 (07) 634-635
35 Nicholas JL, Morgan A, Zachary RB. Idiopathic edema of scrotum in young boys. Surgery 1970; 67 (05) 847-850
36 Planelles Gómez J, Beltrán Armada JR, Beamud Cortés M. , et al. Idiopathic scrotal edema: report of two cases [In Spanish]. Arch Esp Urol 2007; 60 (07) 799-802
37 Sasso F, Nucci G, Palmiotto F, Giustacchini M, Alcini E. Acute idiopathic scrotal oedema: rare disorder or difficult diagnosis?. Int Urol Nephrol 1990; 22 (05) 475-478
38 Thomas AC, Cain MP, Casale AJ, Rink RC. Ultrasound findings of acute idiopathic scrotal edema. Sci World J 2004; 4 (Suppl. 01) 9-10
39 van Langen AM, Gal S, Hulsmann AR, De Nef JJ. Acute idiopathic scrotal oedema: four cases and a short review. Eur J Pediatr 2001; 160 (07) 455-456
40 DaVeiga SP. Epidemiology of atopic dermatitis: a review. Allergy Asthma Proc 2012; 33 (03) 227-234
41 Ting TV. Diagnosis and management of cutaneous vasculitis in children. Pediatr Clin North Am 2014; 61 (02) 321-346
42 Modi S, Mohan M, Jennings A. Acute scrotal swelling in Henoch-Schönlein purpura: case report and review of the literature. Urol Case Rep 2016; 6: 9-11
43 Ferrarini A, Benetti C, Camozzi P. , et al. Acute hemorrhagic edema of young children: a prospective case series. Eur J Pediatr 2016; 175 (04) 557-561