Acute Idiopathic Scrotal Edema: An Important Diagnosis to Consider

Acute idiopathic scrotal edema is a self-limiting condition characterized by significant skin and dartos fascia swelling, sparing the deeper tissues, testes, and epididymis. Its recognition is essential to avoid unnecessary surgical intervention. We report the case of a 7-year-old boy who presented with complicated acute appendicitis and subsequently developed painless, pronounced scrotal edema and erythema two days post-surgery. Ultrasound and Doppler imaging revealed marked scrotal hypervascularity, including the “fountain sign” and hypoechoic thickening of the scrotal wall, while the testes and epididymis appeared normal. Acute idiopathic scrotal edema was diagnosed, and the edema resolved after four days of conservative treatment, confirming the diagnosis.