Massive Pneumoperitoneum After Scuba Diving.
10.3346/jkms.2003.18.2.281
- Author:
Seung Tak OH
1
;
Wook KIM
;
Hae Myung JEON
;
Jeong Soo KIM
;
Kee Whan KIM
;
Seung Jin YOO
;
Eung Kuk KIM
Author Information
1. Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea. endosurg@cmc.cuk.ac.kr
- Publication Type:Case Report
- Keywords:
Pneumoperitoneum;
Diving;
Decompression Sickness
- MeSH:
Adult;
Diving/adverse effects*;
Female;
Human;
Male;
Pneumoperitoneum/diagnosis*;
Pneumoperitoneum/etiology*;
Radiography, Abdominal;
Radiography, Thoracic
- From:Journal of Korean Medical Science
2003;18(2):281-283
- CountryRepublic of Korea
- Language:English
-
Abstract:
Pneumoperitoneum usually indicates rupture of a hollow viscus and considered a surgical emergency. But air may also enter the peritoneum from the lung or the genital organs in female without visceral perforation. While scuba diving, the rapid ascent is usually controlled by placing in a decompression chamber and the excess gas volume is exhaled. Failure to allow this excess gas to escape will result in overdistension of air passage, which may rupture resulting in pulmonary interstitial emphysema or, if air enters the circulation, air embolus can occur. Pneumo-peritoneum is a rare complication of diving accidents. While the majority of cases are not related to an intraabdominal catastrophy, more than 20% have been the result of gastric rupture. We report a 42-yr-old male patient with massive pneumoperitoneum after scuba diving, who presented himself with dyspnea and abdominal distension. Knowledge of this rare condition and its benign course may allow the emergency physician and surgeon to order appropriate studies to help avoid unnecessary surgical treatment. It is important to determine promptly whether the air emanated from a ruptured viscus or was introduced from an extraperitoneal source. Free air in the abdomen does not always indicate a ruptured intra-abdominal viscus.
