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.
Department of Surgical Sciences, Organ Transplantation, and Advanced Technologies, University of Catania, Catania, Italy .
Adriana
A
Toro
Elia
E
Pulvirenti
Isidoro
I
Di Carlo
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*