Anaesthetic and surgical management of gastric perforation secondary to a diving incident: a case report.

Abstract

Gastric perforation secondary to barotrauma is a rare surgical condition which may manifest as an acute abdomen and potentially lead to complications such as pneumoperitoneum. A 50-year-old, healthy, experienced diving instructor was transported to our emergency department for an acute abdomen and severe dyspnoea after a diving incident. Clinical suspicion combined with computed tomography scanning lead to the diagnosis of linear rupture of the stomach. Exsufflation of the abdominal cavity was performed in the emergency department and then the patient was sent to the operating room for emergency laparoscopic gastric repair. Post-operative management was focused on decompressing the stomach with a nasogastric tube and abdominal radiography with barium ingestion was performed to confirm the absence of leakage. The patient was discharged at postoperative day four. We found 16 similar cases in the published literature. Gastric perforation secondary to a diving accident is rare but requires rapid diagnosis and surgical treatment.