Oyaizu Takuya, Enomoto Mitsuhiro, Tsujimoto Toshihide, Kojima Yasushi, Okawa Atsushi, Yagishita Kazuyoshi
Hyperbaric Medical Center, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
Undersea Hyperb Med. 2017 Mar-Apr;44(2):167-171. doi: 10.22462/3.4.2017.11.
We report the case of a 54-year-old male compressed-air worker with gas bubbles detected by computed tomography (CT). He had complained of strong abdominal pain 30 minutes after decompression after working at a pressure equivalent to 17 meters of sea water for three hours. The initial CT images revealed gas bubbles in the intrahepatic portal vein, pulmonary artery and bilateral femoral vein. After the first hyperbaric oxygen treatment (HBO₂ at 2.5 atmospheres absolute/ATA for 150 minutes), no bubbles were detected on repeat CT examination. The patient still exhibited abdominal distension, mild hypesthesia and slight muscle weakness in the upper extremities. Two sessions of U.S. Navy Treatment Table 6 (TT6) were performed on Days 6 and 7 after onset. The patient recovered completely on Day 7. This report describes the important role of CT imaging in evaluating intravascular gas bubbles as well as eliminating the diagnosis of other conditions when divers or compressed-air workers experience uncommon symptoms of decompression illness. In addition, a short treatment table of HBO₂ using non-TT6 HBO₂ treatment may be useful to reduce gas bubbles and the severity of decompression illness in emergent cases.
我们报告一例54岁男性压缩空气工人的病例,其经计算机断层扫描(CT)检测到气泡。他在相当于17米海水压力的环境下工作3小时后减压30分钟,出现剧烈腹痛。最初的CT图像显示肝内门静脉、肺动脉和双侧股静脉有气泡。首次高压氧治疗(2.5绝对大气压/ATA,持续150分钟)后,重复CT检查未发现气泡。患者仍有腹胀、轻度感觉减退和上肢轻度肌无力。发病后第6天和第7天进行了两疗程的美国海军治疗表6(TT6)治疗。患者在第7天完全康复。本报告描述了CT成像在评估血管内气泡以及排除潜水员或压缩空气工人出现不常见减压病症状时其他病症诊断方面的重要作用。此外,在紧急情况下,使用非TT6高压氧治疗的简短治疗表可能有助于减少气泡和减轻减压病的严重程度。