@article{ref1,
title="Diving accident-induced arterial gas embolism",
journal="Nederlands Tijdschrift voor Geneeskunde",
year="2017",
author="Nijk, P. D. and van Rees Vellinga, T. P. and van Lieshout, J. M. and Gaakeer, M. I.",
volume="161",
number="",
pages="D1459-D1459",
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. <br><br>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.<p /> <p>Language: nl</p>",
language="nl",
issn="0028-2162",
doi="",
url="http://dx.doi.org/"
}