Critical Manifestations of Pneumoscrotum

Pneumoscrotum with extensive subcutaneous emphysema in traumatic perineal injury: A case report

Key Clinical Message

We present a rare case of pneumoscrotum with subsequent subcutaneous emphysema in penetrating perineal injury with a tangential wound. It is important to diagnose the underlying disease and treat the cause. An examination under anesthesia is crucial for the diagnosis and management of the set of injuries.

Abstract

Pneumoscrotum with subcutaneous emphysema in traumatic perineal injuries is an alarming sign and may indicate life-threatening intraabdominal injuries or necrotizing fasciitis. We reported a case of pneumoscrotum and extensive subcutaneous emphysema of the abdomen and chest 2 days after admission. Pneumoscrotum was not seen on the initial Computerized tomographic scan.

Non-osseous considerations in diagnostic imaging for pelvic and acetabular trauma

High-quality imaging is crucial for orthopedic traumatologists in the evaluation and management of pelvic and acetabular fractures. Computed tomography (CT) plays an essential role in the diagnosis and treatment of patients with these complex injuries. A thoughtful evaluation of associated soft tissues can reveal additional details about the patient and their injury that may impact treatment. This review aims to highlight soft tissue findings that should be identified when evaluating the initial diagnostic imaging after pelvic and acetabular trauma.

Scrotal emphysema with characteristics of Fournier's gangrene in a community setting

Fournier's gangrene is a life-threatening type of necrotizing fasciitis associated with a high rate of morbidity and mortality. The patient is a 29-year-old incarcerated male who presented to the ED with left-sided scrotal crepitus extending into the axilla and testicular swelling. The patient endorsed a pimple on his left scrotum accompanied with groin pain. He had a prior history of foreign body removal and self-mutilating behaviors. The patient was taken for surgical exploration out of concern due to a subcutaneous emphysema secondary to a necrotizing soft tissue infection.

Pneumoscrotum: A rare complication of ruptured emphysema bullae

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.

Scrotal abscess as a manifestation of posterior duodenal perforation; a very rare presentation

Posterior perforation of duodenal ulcers is very rare; the infection may spread from the retroperitoneal space to the scrotum.

A 75-year-old male presented with painful right scrotal swelling for 2 days associated with fever. During abdominal examination there was abdominal tenderness and scrotal swelling and tenderness.

CT scan of the abdomen showed large amount of air collection in the retroperitoneal space extending to the right scrotum with contrast media passing to the retroperitoneum and right scrotum.

Laparotomy done and there was a perforation in the posterior wall of the duodenum, suturing done and right scrotal abscess drained.

Pneumoscrotum With Extensive Penile and Abdominal Subcutaneous Emphysema: A Case Report of Uncertain Etiology

Pneumoscrotum and subcutaneous emphysema make for impressive findings on examination and imaging. With ranging etiologies, thorough investigation into the source is essential to rule out potentially life threatening situations. We present a 31-year-old man with pneumoscrotum and extensive subcutaneous emphysema of his penis, abdomen, and perineum. History and physical exam didn't reveal a clear cause and he subsequently underwent surgical exploration showing no soft tissue infection. On post-operative day 1, he remained clinically stable and was discharged. Despite the usual benign nature of pneumoscrotum, full assessment is necessary to identify possible underlying conditions of significant morbidity and mortality.