72-Year-Old Man Becomes World's First 'Whistling Scrotum' Patient After Undergoing Surgery

An unnamed 72-year-old man went to an emergency department in Ohio because of the weird hissing noise coming from his genitals. He was also complaining of shortness of breath and a swollen face. He was immediately rushed to a local emergency where he was diagnosed with a "whistling scrotum."

The alarming report of this bizarre disorder was published in a study titled "Whistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound," published in the American Journal of Case Reports.

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72-Year-Old Man Becomes World's First 'Whistling Scrotum' Patient After Undergoing Surgery

World's First Pneumoscrotum Case

The man described in the case study recently undergone surgery to treat his recurrent epididymitis - an inflammation of the coiled tube at the back of the testicles that stores and carries the sperm.

At the hospital, doctors found that he had two collapsed lungs that caused excessive air in his abdomen, perineum, and scrotum, according to Insider. Further analysis also showed that he had an open wound on his scrotum.

Doctors gave him chest tubes for his lungs and transferred him to a bigger hospital for further treatment. He then received another test tube since the other one was not working and only worsened his condition. After three days, his lungs were repaired and he was allowed to go home.

However, there is still air trapped in his perineum, thighs, and scrotum that stayed for a long time. He decided to undergo another surgery to remove his testicles and was finally free of excess air after two years.

Clinicians diagnosed him with pneumoscrotum, an unusual condition typically resulting from trauma or accident. But in the man's case, the open wound in his scrotum allowed air to pass freely inside his body. He was the first man ever to be diagnosed with such a disorder.

According to MailOnline, the medics recalled the man adamantly insisting that he did not self-injected air into his scrotum and his behavior during recovery led them to believe it. The paper had not revealed the exact date when the incident took place.

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About Pneumoscrotum

A 2015 paper published in the journal Therapeutics and Critical Risk Management defined pneumoscrotim as a term used to describe the presence of air in the scrotum. The incidence of pneumoscrotum cases is unclear and experts believe that the actual number of cases is underestimated because the condition is not always reported.

Moreover, pneumoscrotum also includes scrotal emphysema and pneumatocele, which both looks like swelling. But for scrotal emphysema, clinical signs typically show swelling of the scrotum and palpable crepitus. Meanwhile, pneumatocele is not palpable because the air is trapped in the Tunica vaginalis of the testicle.

The etiologies of pneumoscrotum cases could vary as some could be due to a life-threatening disease, like pneumothorax or Fournier gangrene (FG). But ultimately, pneumoscrotum cases are rarely diagnosed.