Pneumoscrotum is a rare injury associated with traumatic pneumothorax following blunt trauma ¹. Free air migrates inferiorly into the paranephric space, through the retroperitoneum and into inguinal canal ².

The three common pathways that result in air tracking into the scrotum are:

1. free air in the abdomen through a patent processus vaginalis
2. retroperitoneal air into the inguinal canal tracking down the superficial fascia covering the spermatic cord
3. direct extension of the subcutaneous emphysema of the trunk via the path of least resistance ³.

The clinical significance is relatively low as the associated injuries are of higher importance, and management is often conservative ⁴.