Kamiimabeppu Daisaku, Baba Kenji, Wada Masumi, Kuroshima Naoki, Kawasaki Yota, Sasaki Ken, Arigami Takaaki, Kitazono Ikumi, Ohtsuka Takao
Department of Gastrointestinal Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan.
Department of Pathology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan.
Surg Case Rep. 2025;11(1). doi: 10.70352/scrj.cr.24-0185. Epub 2025 Apr 10.
Ischemic colitis secondary to decompression sickness (DCS) is rare. Here, we present a case of ischemic colitis resulting in bowel necrosis following DCS.
A 63-year-old male, with a history of hyperbaric oxygen (HBO) therapy for DCS 6 years ago, presented with limb and lower abdominal pain after a 55-m dive. The patient was diagnosed with DCS, and HBO therapy was initiated. However, due to worsening lower abdominal pain, contrast-enhanced computed tomography was performed on the second day. Imaging revealed a poorly enhanced segment extending from the rectum to sigmoid colon suggestive of bowel necrosis. Emergency surgery was performed, and the necrotic bowel segments were resected, followed by a descending colostomy. Pathological examination revealed ischemic colitis.
Ischemic colitis should be considered a differential diagnosis in patients with DCS presenting with abdominal symptoms. Surgical intervention may be required in patients with recurrent DCS, depending on the patient's condition.
减压病（DCS）继发的缺血性结肠炎较为罕见。在此，我们报告一例DCS后发生肠坏死的缺血性结肠炎病例。
一名63岁男性，6年前曾因DCS接受高压氧（HBO）治疗，在进行55米潜水后出现肢体和下腹部疼痛。该患者被诊断为DCS，并开始接受HBO治疗。然而，由于下腹部疼痛加剧，在第二天进行了增强计算机断层扫描。影像学检查显示从直肠至乙状结肠有一段强化不佳的区域，提示肠坏死。遂进行急诊手术，切除坏死肠段，随后行降结肠造口术。病理检查显示为缺血性结肠炎。
对于出现腹部症状的DCS患者，应考虑缺血性结肠炎作为鉴别诊断。对于复发性DCS患者，可能需要根据患者情况进行手术干预。
