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

  • Mohsen Shafiepour Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
  • Mohammad Javad Najafzadeh Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
  • Seyed Mehdi Hashemi Bajgani Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
  • Behnam Dalfardi Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
DOI: https://doi.org/10.31661/gmj.v11i.2372
Keywords: Barotrauma, COVID-19, Noninvasive Ventilation, Pneumoscrotum

Abstract

Background: Patients with Coronavirus disease 2019 (COVID-19) pneumonia are at risk of hypoxemic respiratory failure. Hence, many patients may require noninvasive positive pressure ventilation (NIPPV) during their hospital course. Using mechanical ventilation such as bilevel positive airway pressure or a ventilator to provide NIPPV may result in adverse events, including barotrauma. Case Report: We reported two cases (40- and 43-years-old men) of severe COVID-19 pneumonia and hypoxemic respiratory failure who underwent NIPPV for respiratory support. These cases were complicated with barotrauma in their course of hospital admission that manifested with pneumoscrotum. Conclusion: In the cases of pneumoscrotum, it is crucial to understand its underlying etiology and origin since this clinical finding may be the outcome of life-threatening illnesses requiring urgent treatment.

References

Hamouri S, Samrah SM, Albawaih O, Saleh Z, Smadi MM, et al. Pulmonary barotrauma in COVID-19 patients: Invasive versus noninvasive positive pressure ventilation. Int J Gen Med. 2021;14:2017-32.

https://doi.org/10.2147/IJGM.S314155

PMid:34079341 PMCid:PMC8164351

Faraone A, Beltrame C, Crociani A, Carrai P, Lovicu E, et al. Effectiveness and safety of noninvasive positive pressure ventilation in the treatment of COVID-19-associated acute hypoxemic respiratory failure: a single center, non-ICU setting experience. Intern Emerg Med. 2021;16(5):1183-90.

https://doi.org/10.1007/s11739-020-02562-2

PMid:33222116 PMCid:PMC7680552

Dobler CC, Murad MH, Wilson ME. Noninvasive positive pressure ventilation in patients with COVID-19. Mayo Clin Proc. 2020;95(12):2594-601.

https://doi.org/10.1016/j.mayocp.2020.10.001

PMid:33276832 PMCid:PMC7543969

Bonny R, Moh EN, Aké YL, Kouassi AS, Midékor K, et al. Extensive pneumoscrotum and pneumoperitoneum simulating a compound inguino scrotal hernia in a neonate. Journal of Pediatric Surgery Case Reports. 2017;18:16-8.

https://doi.org/10.1016/j.epsc.2017.01.007

Noujeim JP, Ibrahim S, Noujeim A, Haddad Y. Pneumoscrotum caused by a bronchopleural fistula. Cureus. 2021;13(8):e17270.

https://doi.org/10.7759/cureus.17270

PMid:34540491 PMCid:PMC8448265

Akbulut S, Isik B, Karipkiz Y, Yilmaz S. Massive subcutaneous emphysema, pneumoperitoneum, pneumoretroperitoneum, and pneumoscrotum following endoscopic retrograde cholangiopancreatography in a living liver donor. Int J Organ Transplant Med. 2018;9(3):132-5.

https://doi.org/10.26226/morressier.58eb975ed462b80290b4fe45

Khan MS, Jamal F, Khan Z, Tiwari A, Simo H, et al. ERCP-related duodenal perforation presenting as pneumoscrotum. Case Rep Gastroenterology. 2018;12(1):1-6.

https://doi.org/10.1159/000485557

PMid:29515338 PMCid:PMC5836279

Edey S, Whitaker J, Vivekanandan S. Pneumoscrotum following computed tomography pneumocolon. BMJ. 2017;357.

https://doi.org/10.1136/bmj.j1825

Sunderland MS, Dakwar A, Rishi A, Bennett RD. Pneumoperitoneum, pneumoretroperitoneum, and pneumoscrotum following transanal excision of rectal polyp. Am Surg. 2020:3134820956359.

https://doi.org/10.1177/0003134820956359

PMid:33342273

Humayun A, Chai LF, Pontell ME, Jankowski MA. Pneumoscrotum: Value as an early diagnostic sign of tension pneumothorax in blunt thoracic trauma. Int J Crit Illn Inj Sci. 2018;8(4):210-3.

https://doi.org/10.4103/IJCIIS.IJCIIS_52_18

PMid:30662868 PMCid:PMC6311965

Jandou I, Moataz DA, Adnan Ettanji, Dakir Mohammed, Adil Debbagh, et al. Pneumoscrotum: A rare complication of ruptured emphysema bullae. Urol Case Rep. 2021;34:101476.

https://doi.org/10.1016/j.eucr.2020.101476

PMid:33204641 PMCid:PMC7649614

Firmanto R, Widia F, Irdam GA. Pneumoscrotum in patient with pneumothorax: A case report. Urol Case Rep. 2019;27:100915.

https://doi.org/10.1016/j.eucr.2019.100915

PMid:31687351 PMCid:PMC6819812

Published
2022-11-20
How to Cite
Shafiepour, M., Najafzadeh, M. J., Hashemi Bajgani, S. M., & Dalfardi, B. (2022). Pneumoscrotum, a Rare Presentation of Barotrauma Following Noninvasive Positive Pressure Ventilation in Patients with Severe COVID-19 Pneumonia. Galen Medical Journal, 11, e2372. https://doi.org/10.31661/gmj.v11i.2372
Issue
Vol. 11 (2022): 2022
Section
Case Report/Series

Copyright (c) 2022 Galen Medical Journal

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

  • Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
  • Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
  • Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).