Wang J, Corson K, Minky K, Mader J
Division of Hyperbaric Medicine and Wound Care, Department of Orthopedics and Rehabilitation, University of Texas Medical Branch, Galveston, Texas, USA.
Undersea Hyperb Med. 2002 Winter;29(4):242-6.
A 29-year-old man was brought to an emergency department by the United States Coast Guard with chief complaints of severe abdominal pain, right leg paresthesia and weakness following four deep air dives. Physical examination before recompression treatment was remarkable for diffuse abdominal tenderness and right leg weakness. The patient was diagnosed in the emergency room with type II decompression sickness (DCS) and underwent standard recompression therapy. He experienced complete resolution of weakness after hyperbaric oxygen (HBO) therapy, but his abdominal pain was persistent. Further investigation led to the diagnosis of acute appendicitis with perforation. The patient underwent appendectomy and intravenous antibiotic therapy and was discharged to his home on hospital day five without complications. This case reinforces the importance of careful clinical assessment of divers and illustrates the potentially wide differential diagnosis of DCS. This is the first reported case of recompression treatment of a diver with acute appendicitis and type II DCS.
一名29岁男性被美国海岸警卫队送往急诊科，主要症状是在进行四次深度空气潜水后出现严重腹痛、右腿感觉异常和无力。在进行再加压治疗前的体格检查发现有弥漫性腹部压痛和右腿无力。该患者在急诊室被诊断为II型减压病（DCS），并接受了标准的再加压治疗。高压氧（HBO）治疗后，他的无力症状完全缓解，但腹痛持续存在。进一步检查后诊断为急性阑尾炎伴穿孔。患者接受了阑尾切除术和静脉抗生素治疗，于住院第五天出院，无并发症。该病例强调了对潜水员进行仔细临床评估的重要性，并说明了DCS可能存在广泛的鉴别诊断。这是首例关于急性阑尾炎合并II型DCS潜水员的再加压治疗报告病例。
