Article Text

Unusual presentation of more common disease/injury
Perforation of a sigmoid diverticulum presenting with a pneumoscrotum and surgical emphysema
  1. Henry D I De’Ath
  1. Royal London Hospital, Whitechapel, London, E1 1BB, UK
  1. henryde-ath{at}


A case of a sigmoid perforation presenting as a pneumoscrotum with progressive surgical emphysema is reported. An elderly patient presented with a grossly swollen scrotum and a distended abdomen. A computed tomography (CT) scan demonstrated sigmoid diverticulitis in conjunction with air and a subdiaphragmatic collection. A laparotomy was performed and revealed a perforated sigmoid diverticulum (Hinchey III). Sadly the patient died on the operating table. Intra-abdominal pathology manifesting as a pneumoscrotum and surgical emphysema is a rare yet reported phenomenon most often associated with colonoscopy, but also described with appendicitis and perforated colonic carcinoma. In previous reports, in contrast to this patient, the individual’s scrotum was inflamed but not erythematous and tender, and the rapid progression of surgical emphysema is not reported.

  • 617
  • 363
  • 488

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests: none.