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Gastrointestinal Barotrauma

By

Richard E. Moon

, MD, Duke University Medical Center

Last full review/revision Jun 2021| Content last modified Jun 2021
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Small amounts of air swallowed when diving may expand during ascent (gastrointestinal barotrauma), usually causing self-limited symptoms.

Breathing improperly from a regulator or using ear and sinus pressure-equalization techniques may cause divers to 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.

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