[Decompression sickness as differential diagnosis in internal medicine emergency admissions].
Two men (aged 37 years--patient 1, and 26 years--patient 2), both in good health, had dived as a sport to a depth of 40 and 45 m, respectively, reportedly keeping to the prescribed decompression times on their ascent. Patient 1 immediately developed shortness of breath and pain in the chest, later neurological deficits in both legs, as well as faecal and urinary incontinence. Examination 60 h later revealed paraparesis, increased leg proprioceptor reflexes and paraesthesia below the 10th thoracic vertebra, with abnormal posterior column function. After recompression (hyperbaric oxygenation, 6 treatment sessions of 4 h each over 8 days, as prescribed in US Navy Table No. 6) the signs improved and two months later there were no deficits. Patient 2 developed 30 min after a similar dive painful, doughy swellings and redness over the upper ventral half of the thorax and both upper arms. All signs and symptoms disappeared after recompression treatment (hyperbaric oxygenation for 3 h), begun 28 h after the dive. Previously elevated levels for haemoglobin (18.5 g/dl), haematocrit (0.56) and red blood corpuscles (5.98 x 10(6)/microliters) returned to normal. The described neurological abnormalities are typical for type II, redness and joint pains for type I decompression sickness.
Göke
M
M
I. Medizinische Klinik und Poliklinik, Universitätsklinikum, Mainz.
Knittel
T
T
Staritz
M
M
Brost
F
F
Röder
R
R
Meyer zum Büschenfelde
K H
KH
D000328:Adult; D003665:Decompression Sickness / Q000175:diagnosis* / Q000628:therapy; D003937:Diagnosis, Differential; D004242:Diving / Q000009:adverse effects; D004630:Emergencies; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D013997:Time Factors
Dekompressionskrankheit als Differentialdiagnose in der internistischen Notaufnahme.