Massive Scrotal Edema: An Unusual Manifestation of Obstructive Sleep Apnea and Obesity-Hypoventilation Syndrome

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 hypertensio...

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Main Authors: Stephanie E. Dreifuss, Ernest K. Manders
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2013/685716
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author Stephanie E. Dreifuss
Ernest K. Manders
author_facet Stephanie E. Dreifuss
Ernest K. Manders
author_sort Stephanie E. Dreifuss
collection DOAJ
description 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.
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spelling doaj-art-f8dd400e5b8d423ab3c60f5590d34b5c2025-02-03T01:31:41ZengWileyCase Reports in Medicine1687-96271687-96352013-01-01201310.1155/2013/685716685716Massive Scrotal Edema: An Unusual Manifestation of Obstructive Sleep Apnea and Obesity-Hypoventilation SyndromeStephanie E. Dreifuss0Ernest K. Manders1School of Medicine, University of Pittsburgh, S532 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15213, USADepartment of Plastic and Reconstructive Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USAObstructive 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.http://dx.doi.org/10.1155/2013/685716
spellingShingle Stephanie E. Dreifuss
Ernest K. Manders
Massive Scrotal Edema: An Unusual Manifestation of Obstructive Sleep Apnea and Obesity-Hypoventilation Syndrome
Case Reports in Medicine
title Massive Scrotal Edema: An Unusual Manifestation of Obstructive Sleep Apnea and Obesity-Hypoventilation Syndrome
title_full Massive Scrotal Edema: An Unusual Manifestation of Obstructive Sleep Apnea and Obesity-Hypoventilation Syndrome
title_fullStr Massive Scrotal Edema: An Unusual Manifestation of Obstructive Sleep Apnea and Obesity-Hypoventilation Syndrome
title_full_unstemmed Massive Scrotal Edema: An Unusual Manifestation of Obstructive Sleep Apnea and Obesity-Hypoventilation Syndrome
title_short Massive Scrotal Edema: An Unusual Manifestation of Obstructive Sleep Apnea and Obesity-Hypoventilation Syndrome
title_sort massive scrotal edema an unusual manifestation of obstructive sleep apnea and obesity hypoventilation syndrome
url http://dx.doi.org/10.1155/2013/685716
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