Titu Liviu V, Laden Gerard, Purdy Gerard M, Wedgwood Kevin R
Academic Surgical Unit, Castle Hill Hospital, Castle Road, Cottingham, North Humberside HU16 5JQ, UK.
Surg Today. 2003;33(4):299-301. doi: 10.1007/s005950300067.
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.
胃破裂可能是潜水后快速上升过程中压缩空气膨胀的结果。我们报告一例中年女性潜水后上浮过快导致胃撕裂的病例，并通过回顾既往报道的类似事件来讨论此类患者的诊断和管理。即使没有明显的腹膜刺激体征，对于主诉腹痛的潜水者也应怀疑胃气压伤。虽然这些患者总是存在气腹，但气腹也可能是肺气压伤的结果，因此胃镜检查或放射学对比研究，或两者兼用，对于明确诊断至关重要。手术修复是活动性全层撕裂的首选治疗方法，如果伴有动脉气体栓塞或减压病，理想情况下应在具备I类（有重症监护能力）高压氧舱的中心进行。
