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

Maristella Santi
1   Department of Pediatrics, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Switzerland
,
Sebastiano A. G. Lava
2   Department of Pediatrics, University Children's Hospital of Bern, and University of Bern, Bern, Switzerland
,
Giacomo D. Simonetti
1   Department of Pediatrics, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Switzerland
,
Mario G. Bianchetti
1   Department of Pediatrics, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Switzerland
,
Gregorio P. Milani
3   Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
› Institutsangaben
Weitere Informationen

Publikationsverlauf

27. Februar 2017

29. März 2017

Publikationsdatum:
15. Mai 2017 (online)

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.

 
  • 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