Gastric barotrauma in a scuba diver: report of a case.

Stomach rupture can occur as a consequence of the expansion of compressed air during rapid ascent after diving. We present the case of a middle-aged woman who suffered a gastric tear from surfacing too quickly after diving, and discuss the diagnosis and management of such patients by reviewing previously reported similar events. Gastric barotrauma should be suspected in divers who complain of abdominal pain, even in the absence of frank signs of peritoneal irritation. Although pneumoperitoneum is always present in these patients, it can also occur as a consequence of pulmonary barotrauma, making gastroscopy or radiological contrast studies, or both, essential for a definitive diagnosis. Surgical repair represents the treatment of choice for an active full-thickness tear and, if associated with arterial gas embolism or decompression sickness, should ideally be performed in a center where a category I (intensive care-capable) hyperbaric unit is available.