Should computed chest tomography be recommended in the medical certification of professional divers? A report of three cases with pulmonary air cysts.
Pulmonary barotrauma (PBT) is a recognised risk of compressed gas diving. Any reason that causes air trapping in the lung during ascent may cause PBT by increasing intrapulmonary pressure. Chest x ray examination is mandatory for medical certification of the professional divers in many countries, but pulmonary air trapping lesions such as an air cyst in the lungs cannot always be detected by plain chest x ray examination. Computed tomography (CT) is a reliable, but expensive measure for detecting pulmonary abnormalities in divers. Three cases with pulmonary air cysts are reported in which air cysts were invisible on the x ray pictures, but well defined by CT. It is impractical and not cost effective to perform CT for medical certification of all divers, but it can be an option to recommend CT once during the initial examination of the candidates for professional diving, especially if there is a history of predisposing factors, such as smoking or pulmonary infections.
Toklu
A S
AS
Istanbul University, Istanbul Faculty of Medicine, Department of Underwater and Hyperbaric Medicine, Istanbul, Turkey. akin@toklu.net
Kiyan
E
E
Aktas
S
S
Cimsit
M
M
D000328:Adult; D001469:Barotrauma / Q000000981:diagnostic imaging* / Q000517:prevention & control; D002568:Certification; D003560:Cysts / Q000000981:diagnostic imaging*; D003665:Decompression Sickness / Q000000981:diagnostic imaging / Q000517:prevention & control; D004242:Diving / Q000293:injuries*; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases; D011030:Pneumothorax / Q000150:complications / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed