Gangrene of the Scrotum
Note the swelling of the scrotum occurring with the gangrene. The most common type of gangrene in the male perineal/genital region is called “Fournier Gangrene”, which is caused by a combination of both aerobic and anaerobic bacteria (meaning that it’s a form of gas gangrene). These give off gasses as they feed on the tissue, which can cause scrotal inflation. Complete irreversible necrosis of tissue, toxemia, and shock, are all very common with gas gangrenes. Death is also common.
The other reason that scrotal gangrene can occur is due to ischemia - the restriction or thinning of blood supply to an area, generally due to arterial occlusion. This is known as a dry gangrene. When this occurs, amputation of the affected area can generally halt the progression and prevent death.
An American Text-Book of Genito-Urinary Diseases, Syphilis, and Diseases of the Skin. L. Bolton Bangs, 1898.