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Case Report
Acute idiopathic scrotal edema (AISE): A case report in Al-Ahsa, Saudi Arabia
1 Urology Senior Registrar, Department of Urology, Almoosa Health Group, Al-Ahsa, Mubarraz, Saudi Arabia
2 Urology Consultant, Department of Urology, King Fahad Hofuf Hospital, Al-Ahsa, Hofuf, Saudi Arabia
3 Urology Registrar, Department of Urology, King Fahad Hofuf Hospital, Al-Ahsa, Hofuf, Saudi Arabia
4 Radiology Resident, Department of Radiology, King Fahad Hofuf Hospital, Al-Ahsa, Hofuf, Saudi Arabia
5 Urology Resident, Department of Urology, King Fahad Hofuf Hospital, Al-Ahsa, Hofuf, Saudi Arabia
6 Medical Student, College of Medicine, Imam Abdulrahman Bin Faisal University, Eastern Province, Dammam, Saudi Arabia
Address correspondence to:
Hassan Ali Aldhneen
Urology Senior Registrar, Department of Urology, Almoosa Health Group, Al-Ahsa, Mubarraz,
Saudi Arabia
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Article ID: 100050Z15AA2025
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Aldehneen HA, Al Nasser M, Allubly N, Alharbi MA, AlBesher MA, Alsamin AA. Acute idiopathic scrotal edema (AISE): A case report in Al-Ahsa, Saudi Arabia. J Case Rep Images Urol 2025;10(1):6–9.ABSTRACT
Introduction: Acute idiopathic scrotal edema (AISE) is a rare, self-limiting condition of uncertain etiology, predominantly affecting children. It is characterized by sudden scrotal swelling and erythema without involvement of the testes or paratesticular structures. While benign, it can mimic more severe conditions like testicular torsion, requiring careful differentiation to avoid unnecessary surgical interventions.
Case Report: We report the case of an 8-year-old boy in Saudi Arabia who presented with acute onset bilateral scrotal swelling, mild erythema, and tenderness, predominantly on the right side. There were no associated fever, trauma, or urinary symptoms. A similar episode two weeks earlier was resolved without medical intervention. Examination revealed generalized scrotal swelling with skin thickening, palpable testicles with normal position and size, and intact cremasteric reflexes. Laboratory results were unremarkable except for mild leukocytosis. Doppler ultrasound showed preserved vascularity of both testicles with characteristic edematous scrotal wall thickening and the “fountain sign,” confirming the diagnosis of AISE. Management and outcome: The patient was managed conservatively with non-steroidal anti-inflammatory drugs (NSAIDs) and intravenous (IV) ceftazidime. The symptoms resolved completely within 48 hours, and he was discharged in good condition with a short course of oral antibiotics. A two-week follow-up showed no recurrence or residual symptoms.
Conclusion: This case underscores the importance of recognizing AISE in pediatric acute scrotum presentations to avoid unnecessary surgery. Clinical evaluation and Doppler ultrasound, highlighting the “fountain sign,” are pivotal for diagnosis. Conservative treatment ensures a rapid and favorable outcome, as demonstrated in this case.
Keywords: Acute idiopathic scrotal edema, Doppler ultrasound, Fountain sign, Non-steroidal anti-inflammatories
SUPPORTING INFORMATION
Author Contributions
Hassan Ali Aldhneen - Conception of the work, Design of the work, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Murad Al Nasser - Conception of the work, Design of the work, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Nasser Allubly - Conception of the work, Design of the work, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Maram Abdullah Alharbi - Conception of the work, Design of the work, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Mohammed Adel AlBesher - Conception of the work, Design of the work, Acquisition of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Ali Abduljalil Alsamin - Conception of the work, Design of the work, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Ali Abduljalil Alsamin et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
