Pneumoscrotum as Complication of Blunt Thoracic Trauma: A Case Report

Abstract

Introduction. Pneumoscrotum is a rare clinical entity. It presents with swollen scrotal sac and sometimes with palpable crepitus. It has many etiologies. One of them is due to blunt trauma of the thoracic cage, causing pneumothorax and/or pneumomediastinum. Case Presentation. We report the case of an 82-year-old male who was transferred to the Emergency Department with signs of respiratory distress after a blunt chest trauma. A CT scan was obtained, and bilateral pneumothoraces with four broken ribs were disclosed. Subcutaneous emphysema expanding from the eyelids to the scrotum was observed, and a chest tube was inserted on the right side with immediate improvement of the vital signs of the patient. Discussion. Pneumoscrotum has three major etiologies: (a) local introduction of air or infection from gas-producing bacteria, (b) pneumoperitoneum, and (c) air accumulation from lungs, mediastinum, or retroperitoneum. These sources account for most of the cases described in the literature. Treatment should be individualized, and surgical consultation should be obtained in all cases. Conclusion. Although pneumoscrotum itself is a benign entity, the process by which air accumulates in the scrotum must be clarified, and treatment must target the primary cause.

Radiographic signs of gastrointestinal perforation in children: A pictorial review

“…Pneumoscrotum usually originates from three sources; intra-peritoneal air passing through the patent processus vaginalis (referred to as scrotal pneumatocele), extra-peritoneal air (from retroperitoneum, mediastinum or lungs) dissecting through fascial layers into scrotal wall and local scrotal causes (trauma, gas gangrene). [ 22 23 ]…”

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

“…Rib fractures and sternal fractures were the most common skeletal injuries; rib fractures account for 13%–97% of these injuries, and sternal fractures for 1%–43%. 6 – 8 Vertebral fractures have been seen less frequently. Pulmonary complications such as hemothorax, pneumothorax, and pneumomediastinum are infrequent but also possible.…”

Use of the initial trauma CT scan to aid in diagnosis of open pelvic fractures

“…These studies are often promptly obtained following initial resuscitation and management, and provide the practitioner with useful clinical information. Extra-luminal airdensities identified on CT scans is abnormal [18][19][20]. Injuries to the integumentary, pulmonary, gastrointestinal, genitourinary and musculoskeletal systems must be evaluated to identify the source of air.…”