Pneumomediastinum or lung damage in breath-hold divers from different mechanisms: a report of three cases

Toklu A. S., Erelel M., Arslan A.

DIVING AND HYPERBARIC MEDICINE, cilt.43, sa.4, ss.232-235, 2013 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 43 Sayı: 4
  • Basım Tarihi: 2013
  • Dergi Adı: DIVING AND HYPERBARIC MEDICINE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.232-235
  • Anahtar Kelimeler: Breath-hold diving, freediving, pulmonary barotrauma, arterial gas embolism, cerebral arterial gas embolism (CAGE), buccal pumping, case reports, PULMONARY BAROTRAUMA, GLOSSOPHARYNGEAL INSUFFLATION, COMPUTED-TOMOGRAPHY, BULLAE, EMBOLISM
  • İstanbul Üniversitesi Adresli: Evet

Özet

Normally pulmonary over-inflation is not an issue during breath-hold diving, in contrast to lung squeeze. Compared with compressed air diving, pulmonary barotrauma is rare in breath-hold diving. Several mechanisms can lead to an increase in intrathoracic pressure in breath-hold diving that may cause alveolar rupture. Here we report three cases of pulmonary barotrauma in breath-hold diving. Using high-resolution chest tomography, bullous damage in Case I, and pneumomediastinum in Cases 2 and 3 were detected. Transient neurological symptoms in Cases 1 and 2 suggested cerebral arterial gas embolism. The mechanisms that caused intrapulmonary overpressure were, respectively, lung packing ('buccal pumping'), considerable effort and straining at depth, and breathing compressed air at depth and ascending without exhaling. All three cases recovered without specific treatment such as recompression.