Pneumoscrotum: A rare complication of ruptured emphysema bullae

Abstract

Subcutaneous emphysema and pneumoscrotum due to spontaneous pneumothorax is a rare clinical situation. We present the case of an 82 year old man who was admitted to the emergency department in state of respiratory distress and scrotum increased in size, painful and rapidly progressive installation. Clinical evaluation revealed scrotal emphysema associated with diffuse subcutaneous emphysema in the trunk, the face and both upper limbs. The treatment of this pathology is not yet standardized; antibiotic therapy and close monitoring are recommended.

Pneumoscrotum, a Rare Presentation of Barotrauma Following Noninvasive Positive Pressure Ventilation in Patients with Severe COVID-19 Pneumonia

“…Firmanto et al reported another similar case of pneumoscrotum following pneumothorax [12]. Air movement into the scrotum can occur through the following routes: via the tunica vaginalis from an intra-abdominal source, via the inguinal canal from a retroperitoneal origin, and via the subcutaneous route by direct extension from the trunk (including chest) [11]. The latter route can explain how our patients presented with pneumoscrotum following pulmonary barotrauma.…”

“…For example, Humayun et al [10] described a 37-yearold man with pneumoscrotum as a symptom of tension pneumothorax owing to blunt thoracic trauma. Jandou et al reported this clinical manifestation after the rupture of bullous emphysema in an 82-year-old man [11]. Firmanto et al reported another similar case of pneumoscrotum following pneumothorax [12].…”

Pneumoscrotal Emphysema

“…The diagnosis of scrotal emphysema is often easy, palpation of the air in the scrotal sac confirms the diagnosis, additionally other diagnostic methods such as CT and X-rays can detect the presence of air in the scrotum [12,13]. The diagnosis of scrotal emphysema usually comes with finding the source of air leak within the patient.…”