Pneumoscrotum: A sign of intestinal perforation in a preterm neonate

A preterm male newborn, treated in the neonatal intensive care, presented with mild abdominal distension and enlarged inguinal hernias, in his second week of life. Plain radiographs showed pneumoscrotum and a falciform ligament sign. An exploratory laparotomy was performed, confirming the diagnosis of spontaneous intestinal perforation. When the suspicion of gastrointestinal perforation is raised, careful consideration of every radiological or clinical sign is essential in order to achieve early diagnosis. In this case, pneumoscrotum played an important diagnostic role and should not be misinterpreted as an inguinal hernia.