Citation

Nijk PD, van Rees Vellinga TP, van Lieshout JM, Gaakeer MI. Ned. Tijdschr. Geneeskd. 2017; 161: D1459.

Vernacular Title

Arteriële gasembolieën na een duikongeval.

Affiliation

Admiraal De Ruyter Ziekenhuis, afd. Spoedeisende Geneeskunde, Goes.

Copyright

(Copyright © 2017, Erven Bohn)

DOI

unavailable

PMID

28880140

Abstract

BACKGROUND: During scuba diving, nitrogen dissolves into the body tissues due to elevated pressure under water. During a sudden drop in pressure due to a rapid return to the water surface, arterial gas embolism can arise from pulmonary barotrauma. In a later phase, nitrogen bubbles can also arise in the venous circulation (decompression sickness). Arterial bubbles can incur vascular damage, obstruction, hypoxia and infarction. CASE DESCRIPTION: A 53-year-old healthy sport diver presented at the emergency department in a hypovolemic shock with progressive paresis of all the extremities. He had made an emergency ascent from a depth of 47 meter. During recompression therapy his condition deteriorated. It transpired that he had an patent foramen ovale. As a consequence of this, nitrogen bubbles due to decompression sickness entered the arterial circulation. Despite maximum therapeutic intervention the patient remained paretic.

CONCLUSION: After an ill-fated dive, this patient with patent foramen ovale contracted arterial gas embolism due to pulmonary barotrauma and, at a later stage, decompression sickness. There was increasing damage to the spinal cord resulting in severe physiological disruption.

Language: nl