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January 16, 1978

Spontaneous Pneumoperitoneum After Scuba Diving

Author Affiliations

From the Departments of Anesthesiology (Dr Rose) and Surgery (Dr Jarczyk), University of Florida College of Medicine, Gainesville, Fla. Dr Rose is now with the Department of Anesthesiology, University of California, Irvine, Calif; he is also the director of the Surgical Intensive Care Unit, Veterans Administration Hospital, Long Beach, Calif.

JAMA. 1978;239(3):223. doi:10.1001/jama.1978.03280300055022

SPONTANEOUS pneumoperitoneum is an unusual condition that, to our knowledge, has not been reported as a consequence of scuba diving.

Report of a Case  A 29-year-old man, who was underwater cave diving at a depth of 30 m for 1 1/2 hours, was forced to make an emergency ascent without taking the recommended decompression stops. Within one hour of surfacing, he began to experience pain in his right elbow, left shoulder, and left hip; he also had a bilateral frontal headache. In the hospital emergency room, the patient reported having no visual symptoms, weakness, sensory loss, chest pain, dyspnea, or abdominal pain. Decompression sickness was diagnosed, and he submitted to a recompression regimen. Postero-anterior and lateral chest roentgenograms showed the presence of pneumoperitoneum without pneumothorax, pneumomediastinum, or subcutaneous air. A left lateral decubitus film confirmed the presence of free air in the abdomen as well as emphysematous bullae in the