[abstract] SEVERE ESOPHAGEAL BLEEDING AFTER SCUBA DIVING: A CASE REPORT

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[abstract] SEVERE ESOPHAGEAL BLEEDING AFTER SCUBA DIVING: A CASE REPORT

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Title: [abstract] SEVERE ESOPHAGEAL BLEEDING AFTER SCUBA DIVING: A CASE REPORT
Author: Mueller, PHJ; Franke, A; Benninger, J
Abstract: Introduction: During diving many physiologic functions are altered, especially relating to respiration and circulation. Some pre-existing diseases are therefore considered as contraindications to diving, since diving may lead to progression of the condition in the long term, acute worsening of the disease, or the divers safety may be impaired. We report on a diver with severe esophageal variceal bleeding induced by scuba diving. Materials and Methods: A 39-year-old healthy male without any complaints, but a history of regular alcohol intake and slightly elevated transaminases experienced malaise after scuba diving on the first day of his holidays in the Maldives. The next day he suffered from hematemesis and later on melaena. He was referred to a local hospital, where gastrointestinal bleeding was suspected. Due to the lack of appropriate equipment an endoscopy was not carried out. He was resuscitated with intravenous fluids and blood transfusions, and gastric ice water lavage was performed repeatedly. He recovered from the hemorrhagic shock without any further episode of bleeding and returned home at the end of his scheduled holiday. Results: Subsequently hepatitis C with complete liver cirrhosis, class Child-Pugh A, and esophageal varices grade 2 were diagnosed. An endoscopic rubber band ligation was performed several times, until the varices had disappeared. Thereafter, therapy for hepatitis C with pegylated interferon and ribavirin was started and he was recommended to stop scuba diving. Conclusions: In this case aggravation of portal hypertension by diving is suspected to have caused rupture of an esophageal varix. It is questionable whether a routine medical examination for sports divers would have revealed hepatitis C and liver cirrhosis in this asymptomatic patient and, therefore, whether this diving related gastrointestinal bleeding could have been prevented. However, it is recommended that individuals with a history of esophageal bleeding should stop diving.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/1433
Date: 2004

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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