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. 2015 Apr 9:11:581-7.
doi: 10.2147/TCRM.S77326. eCollection 2015.

Pneumoscrotum: report of two different cases and review of the literature

Giovanni Cochetti  1 , Francesco Barillaro  1 , Emanuele Cottini  1 , Francesco D'Amico  1 , Alberto Pansadoro  1 , Solajd Pohja  1 , Andrea Boni  1 , Roberto Cirocchi  2 , Veronica Grassi  2 , Rosa Mancuso  1 , Elisa Silvi  1 , Katifenia Ioannidou  1 , Maria Giulia Egidi  1 , Giulia Poli  1 , Ettore Mearini  1
Affiliations

Pneumoscrotum: report of two different cases and review of the literature

Giovanni Cochetti et al. Ther Clin Risk Manag. .

Abstract

Pneumoscrotum is the term used to describe the presence of air within the scrotum and includes scrotal emphysema as well as pneumatocele. The etiology varies; in some cases, pneumoscrotum may be due to life-threatening disease like pneumothorax or Fournier gangrene. Despite this, pneumoscrotum is a rarely debated issue. We present two different cases of pneumoscrotum and a review of the literature. The first case report is about a 29 year old male patient affected by Duchenne syndrome who showed pneumoscrotum after cardiopulmonary resuscitation that was performed for asphyxic crisis and cardiovascular arrest. We carried out local puncture with an 18-gauge needle, and the pneumoscrotum was successfully solved. The second case report is about a 56 year old male with pneumoscrotum due to Fournier gangrene who underwent radical exeresis of all necrotic tissues and drainage. This is why most of the scrotal skin and all of the penis skin were removed; as a result, the testicles, epididymis, and cavernosa corpora were externalized. On postoperative day one, the patient was feverless and underwent hyperbaric chamber therapy. No postoperative complications occurred. Accurate evaluation of the pneumoscrotum is always needed. Despite the benign course of most of the clinically evident pneumoscrotum cases, this condition should never be underestimated.

Keywords: Fournier gangrene; cardiopulmonary resuscitation; pneumoscrotum; spontaneous causes; traumatic causes.

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Figures

Figure 1
Figure 1
Computed tomography scans of pneumoscrotum in the patient in case report 1. Note: The arrows show the air-path of the pneumoscrotum.
Figure 2
Figure 2
Necrotic tissues of the patient in case report 2.
Figure 3
Figure 3
For the patient in the second case report, most of the scrotal skin and all of the penis skin were removed; this externalized the testes, epididymides, and cavernosa corpora.
Figure 4
Figure 4
Etiopathogenetic classification and incidence of pneumoscrotum.
Figure 5
Figure 5
Causes of traumatic pneumoscrotum.
Figure 6
Figure 6
Causes of spontaneous pneumoscrotum.
See this image and copyright information in PMC

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