自发性结肠穿孔致阴囊气肿1例报告及文献复习

Pneumoscrotum Induced by Spontaneous Colon Perforation:A Case Report and Review of the Literature

报告1例结肠自发穿孔导致阴囊气肿的临床资料。患者男,66岁,发热、腹痛、阴囊肿痛,轻度腹膜炎体征,阴囊肿胀,皮下握雪感。超声示阴囊皮下积气。CT:左腰大肌及髂腰肌肿胀伴积气。手术探查阴囊内积脓向上延续至腹膜后巨大脓腔与降结肠裂孔相通。由于结肠自发穿孔合并阴囊气肿临床罕见,结肠腹膜外穿孔症状相对较轻且出现较晚,故早期出现阴囊气肿应引起重视。

One case of pneumoscrotum associated with spontaneous colon perforation was reported. The patients was a 66-year-old man, presented with high temperature, mild abdominal pain and an enlarged scrotum. Physical examination revealed scrotal swelling, abdominal tenderness and muscular defense. Computed tomograhy （CT） of the abdomen showed swelling and pneumatosis of the left major psoas and iliopsoas muscles, and ultrasound found subcutaneous emphysema of the scrotum. Surgical investigation discovered a retroperitoneal perforation in the decending colon connected with a huge retroperitoneal vomica and scrotal sac. Spontaneous colon perforation induced pneumoscrotum is rare clinically. It may present as colon perforation, which calls for special attention.