(See also Overview of Diving Injuries Overview of Diving Injuries More than 1000 diving-related injuries occur annually in the United States; > 10% are fatal. Similar injuries can befall workers in tunnels or caissons (watertight retaining structures used... read more and Overview of Barotrauma Overview of Barotrauma Barotrauma is tissue injury caused by a pressure-related change in body compartment gas volume in air-containing areas. During ascent, gas expansion can affect the lungs and gastrointestinal... read more .)
Divers may inadvertently swallow small amounts of air during a dive. This air expands during ascent, causing abdominal fullness, cramps, pain, belching, and flatulence; these symptoms are self-limited. Gastrointestinal (GI) rupture rarely occurs, manifesting with severe abdominal pain and tenderness with rebound and guarding.
If signs of GI rupture are present, immediate upright chest x-ray or CT is done to detect free air. Milder symptoms require no testing.
Patients with GI rupture require aggressive fluid resuscitation, broad-spectrum antibiotic therapy, and immediate surgical consultation for possible exploratory laparotomy.