Scrotal edema

A 62-year-old man, followed for non-ischemic dilated cardiomyopathy was admitted to our hospital with acute cardiac decompensation. He presented dyspnea on effort, a slight edema of the lower limbs taking the cup. The initial physical examination revealed hypotension (100/80 mm Hg), a regular heart rhythm. The examination also showed a giant scrotal edema with intussusception of the penis in the scrotum. A testicular ultrasound was performed showing morphologically normal and well-vascularized testicles and soft tissue edema. After ten days of intravenous administration of diuretic therapy, scrotal edema was completely resolved with the penis appearing in its normal position. Congestive heart failure is usually associated with fluid accumulation in the abdomen and lower limb, with the appearance of mild scrotal edema being a common finding. The clinical presentation in our case, the edema is concentrated in the scrotum, and an unusual presentation of total burial of the penis, with minimal swelling of the lower limbs.