K. Tetzlaff et al., PULMONARY BAROTRAUMA OF A DIVER USING AN OXYGEN REBREATHING DIVING APPARATUS, Aviation, space, and environmental medicine, 67(12), 1996, pp. 1198-1200
A 22-yr-old healthy male diver performed a dive using a closed circuit
oxygen rebreathing apparatus according to normal procedure. After the
dive he developed clinical symptoms of mediastinal emphysema. A chest
X-ray taken 1 d after the dive showed a discrete ''tram track'' sign
in the left paracardial region. Spiral volumetric computed tomography
of the chest 4 d postinjury detected a small subpleural emphysematous
bulla next to the left ventricle, the pneumomediastinum being absorbed
in the meantime. Clinical outcome of pulmonary decompression barotrau
ma in the case of oxygen rebreathing may be different from that in com
pressed air diving, due to the altered gas physics. The necessity for
computed tomography of the chest is emphasized, preferably using the s
piral mode, in any case of suspected pulmonary barotrauma.