Pneumoscrotum Caused by a Bronchopleural Fistula

Abstract

Pneumoscrotum is the term used to indicate the presence of air in the scrotum and comprises scrotal emphysema and pneumatocele. It is an uncommon medical condition and encompasses multiple etiologies, some of which may be life-threatening. We present the case of a 45-year-old male who developed a pneumoscrotum seven days after undergoing a thoracoscopy with decortication, pleural biopsy, and chest tube insertion, for a loculated pleural effusion not amenable to drainage by a pigtail catheter. The patient was diagnosed with a bronchopleural fistula and was treated conservatively with negative chest tube pressure. Treatment of the fistula and of the resulting pneumothorax allowed resorption of the pneumoscrotum. The associated literature is reviewed after the case presentation. This case report underlines the importance of evaluating a pneumoscrotum that should not be underestimated.

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

“…Pneumoscrotum can be seen in the forms of scrotal emphysema (i.e., a condition in which air is seen in the subcutaneous layer of the scrotal tissue) and pneumatocele (meaning the presence of air in the tunica vaginalis) [5]. Clinically, scrotal emphysema can lead to local pain and scrotum swelling accompanied by palpable crepitus [5].…”

“…While scrotal pneumatocele presents with a generalized scrotal swelling that results in inability of palpation of intra-scrotal structures by the examiner [5]. Based on its cause, pneumoscrotum may occur in childhood or adulthood [4].…”