Massive Scrotal Edema: An Unusual Manifestation of Obstructive Sleep Apnea and Obesity-Hypoventilation Syndrome
Identifieur interne : 003420 ( Main/Exploration ); précédent : 003419; suivant : 003421Massive Scrotal Edema: An Unusual Manifestation of Obstructive Sleep Apnea and Obesity-Hypoventilation Syndrome
Auteurs : Stephanie E. Dreifuss [États-Unis] ; Ernest K. Manders [États-Unis]Source :
- Case Reports in Medicine [ 1687-9627 ] ; 2013.
Abstract
Obstructive sleep apnea (OSA) may occur in association with obesity-hypoventilation (Pickwickian) syndrome, a disorder of ventilatory control affecting individuals with morbid obesity. Through the pressor effects of chronic hypercapnia and hypoxemia, this syndrome may result in pulmonary hypertension, right heart failure, and massive peripheral edema. We present a case of severe scrotal edema in a 36-year-old male with OSA and obesity-hypoventilation syndrome. A tracheostomy was performed to relieve hypoxemia and led to dramatic improvement of scrotal edema. No scrotal surgery was necessary. Followup at two months showed complete resolution of scrotal edema, improvement in mental status, and normalization of arterial blood gas measurements. This case demonstrates that OSA and obesity-hypoventilation syndrome may present with massive scrotal edema. Furthermore, if OSA is recognized as the cause of right heart failure, and if the apnea is corrected, the resultant improvement in cardiac function may allow reversal of massive peripheral, including scrotal, edema.
Url:
DOI: 10.1155/2013/685716
PubMed: 23533435
PubMed Central: 3600137
Affiliations:
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Dreifuss</name><affiliation wicri:level="4"><nlm:aff id="I1">School of Medicine, University of Pittsburgh, S532 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15213, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>School of Medicine, University of Pittsburgh, S532 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15213</wicri:regionArea><orgName type="university">Université de Pittsburgh</orgName><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Manders, Ernest K" sort="Manders, Ernest K" uniqKey="Manders E" first="Ernest K." last="Manders">Ernest K. Manders</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Plastic and Reconstructive Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA</wicri:regionArea><wicri:noRegion>PA</wicri:noRegion></affiliation></author></analytic><series><title level="j">Case Reports in Medicine</title><idno type="ISSN">1687-9627</idno><idno type="eISSN">1687-9635</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Obstructive sleep apnea (OSA) may occur in association with obesity-hypoventilation (Pickwickian) syndrome, a disorder of ventilatory control affecting individuals with morbid obesity. Through the pressor effects of chronic hypercapnia and hypoxemia, this syndrome may result in pulmonary hypertension, right heart failure, and massive peripheral edema. We present a case of severe scrotal edema in a 36-year-old male with OSA and obesity-hypoventilation syndrome. A tracheostomy was performed to relieve hypoxemia and led to dramatic improvement of scrotal edema. No scrotal surgery was necessary. Followup at two months showed complete resolution of scrotal edema, improvement in mental status, and normalization of arterial blood gas measurements. This case demonstrates that OSA and obesity-hypoventilation syndrome may present with massive scrotal edema. Furthermore, if OSA is recognized as the cause of right heart failure, and if the apnea is corrected, the resultant improvement in cardiac function may allow reversal of massive peripheral, including scrotal, edema.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Epstein, Lj" uniqKey="Epstein L">LJ Epstein</name></author><author><name sortKey="Kristo, D" uniqKey="Kristo D">D Kristo</name></author><author><name sortKey="Strollo, Pj" uniqKey="Strollo P">PJ Strollo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chervin, Rd" uniqKey="Chervin R">RD Chervin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bradley, Td" uniqKey="Bradley T">TD Bradley</name></author><author><name sortKey="Shapiro, Cm" uniqKey="Shapiro C">CM Shapiro</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bradley, Td" uniqKey="Bradley T">TD Bradley</name></author><author><name sortKey="Floras, Js" uniqKey="Floras J">JS Floras</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lombardi, C" uniqKey="Lombardi C">C Lombardi</name></author><author><name sortKey="Rocchi, R" uniqKey="Rocchi R">R Rocchi</name></author><author><name sortKey="Montagna, P" uniqKey="Montagna P">P Montagna</name></author><author><name sortKey="Silani, V" uniqKey="Silani V">V Silani</name></author><author><name sortKey="Parati, G" uniqKey="Parati G">G Parati</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Aurora, Rn" uniqKey="Aurora R">RN Aurora</name></author><author><name sortKey="Casey, Kr" uniqKey="Casey K">KR Casey</name></author><author><name sortKey="Kristo, D" uniqKey="Kristo D">D Kristo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kessler, R" uniqKey="Kessler R">R Kessler</name></author><author><name sortKey="Chaouat, A" uniqKey="Chaouat A">A Chaouat</name></author><author><name sortKey="Schinkewitch, P" uniqKey="Schinkewitch P">P Schinkewitch</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Miyata, S" uniqKey="Miyata S">S Miyata</name></author><author><name sortKey="Noda, A" uniqKey="Noda A">A Noda</name></author><author><name sortKey="Nakata, S" uniqKey="Nakata S">S Nakata</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Randerath, Wj" uniqKey="Randerath W">WJ Randerath</name></author><author><name sortKey="Verbraecken, J" uniqKey="Verbraecken J">J Verbraecken</name></author><author><name sortKey="Andreas, S" uniqKey="Andreas S">S Andreas</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Guilleminault, C" uniqKey="Guilleminault C">C Guilleminault</name></author><author><name sortKey="Simmons, Fb" uniqKey="Simmons F">FB Simmons</name></author><author><name sortKey="Motta, J" uniqKey="Motta J">J Motta</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Won, Chj" uniqKey="Won C">CHJ Won</name></author><author><name sortKey="Li, Kk" uniqKey="Li K">KK Li</name></author><author><name sortKey="Guilleminault, C" uniqKey="Guilleminault C">C Guilleminault</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Glenn, Jf" uniqKey="Glenn J">JF Glenn</name></author><author><name sortKey="Weinerth, Jl" uniqKey="Weinerth J">JL Weinerth</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ferri, Ff" uniqKey="Ferri F">FF Ferri</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Weinberger, Ln" uniqKey="Weinberger L">LN Weinberger</name></author><author><name sortKey="Zirwas, Mj" uniqKey="Zirwas M">MJ Zirwas</name></author><author><name sortKey="English, Jc" uniqKey="English J">JC English</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Modolin, M" uniqKey="Modolin M">M Modolin</name></author><author><name sortKey="Mitre, Ai" uniqKey="Mitre A">AI Mitre</name></author><author><name sortKey="Da Silva, Jcf" uniqKey="Da Silva J">JCF da Silva</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gibson, T" uniqKey="Gibson T">T Gibson</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Pennsylvanie</li></region><settlement><li>Pittsburgh</li></settlement><orgName><li>Université de Pittsburgh</li></orgName></list><tree><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Dreifuss, Stephanie E" sort="Dreifuss, Stephanie E" uniqKey="Dreifuss S" first="Stephanie E." last="Dreifuss">Stephanie E. Dreifuss</name></region><name sortKey="Manders, Ernest K" sort="Manders, Ernest K" uniqKey="Manders E" first="Ernest K." last="Manders">Ernest K. Manders</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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