Pneumoscrotum due to perforated peptic ulcer previously sutured by laparoscopy.
Pneumoscrotum is a rare condition defined by the presence of gas within the scrotum. Most cases are associated with the pneumoperitoneum; the condition has been described after various diagnostic and therapeutic procedures and disease conditions. In this article, we report a case of a patient admitted to the emergency department for right-upper quadrant abdominal pain. Abdominal X-ray showed free air in the right subdiaphragm; computed tomography (CT) confirmed free air in the abdomen and detected free fluid in the pelvis. The patient underwent laparoscopy, at which time a 1-cm perforation on the anterior wall of the gastric antrum near the pylorus was identified. The perforation was sutured with three detached stitches of reabsorbable material. Approximately 2 days after the surgical procedure, physical examination of the patient showed significant scrotal swelling suspicious for the presence of subcutaneous air. A CT scan confirmed the presence of the pneumoscrotum. The patient returned to the operating room and underwent an exploratory laparotomy. A new perforation was identified beneath the previous one and was sutured with two detached stitches. The patient was discharged uneventfully after 8 days of hospitalization. Pneumoscrotum should be recognized as an early sign of recurrence in patients operated on laparoscopically for peptic ulcer.
Toro
Adriana
A
Department of Surgical Sciences, Organ Transplantation, and Advanced Technologies, University of Catania, Catania, Italy .
Pulvirenti
Elia
E
Di Carlo
Isidoro
I
D000293:Adolescent; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D010439:Peptic Ulcer Perforation / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D012611:Scrotum; D013352:Subcutaneous Emphysema / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D013536:Suture Techniques / Q000009:adverse effects*