Mellem H, Emhjellen S, Horgen O
Department of Pulmonary Medicine, Ullevål Hospital, Oslo, Norway.
Aviat Space Environ Med. 1990 Jun;61(6):559-62.
A 23-year-old female self-contained underwater breathing apparatus (SCUBA) diver developed central nervous symptoms and signs of arterial gas embolism when surfacing after 15 min at a depth of 18 m. The dive had been performed according to normal procedure. In the hospital, chest X-ray and computer tomography of the chest showed a large emphysematous bulla in the left hemithorax. Recompression treatment was not performed. Reexamination of old X-rays showed an emphysematous bulla on the left side which had been present before the dive. She made a complete recovery. Emphysematous bullae may be a more common cause of pulmonary barotrauma than is realised. Bullae visible on computer tomograms or magnetic resonance imaging may not be visible on conventional X-rays. The case reported illustrates the need for a consensus on the procedures necessary for the medical screening of diving candidates.
一名23岁的女性水肺潜水员在18米深处潜水15分钟后浮出水面时出现了中枢神经系统症状和动脉气体栓塞体征。此次潜水是按照正常程序进行的。在医院里，胸部X线和胸部计算机断层扫描显示左半胸有一个大的肺气肿性肺大疱。未进行加压治疗。对旧的X线片复查显示潜水前左侧就已存在肺气肿性肺大疱。她完全康复了。肺气肿性肺大疱可能是肺气压伤比人们意识到的更常见的原因。计算机断层扫描或磁共振成像上可见的肺大疱在传统X线片上可能看不见。所报告的病例说明了在潜水候选人医学筛查所需程序上达成共识的必要性。
