Background: The treatment of decompression sickness (DCS) with hyperbaric oxygen (HBO2) serves to decrease intravascular bubble size, increase oxygen (O2) delivery to tissue and enhance the elimination of inert gas. Emulsified perfluorocarbons (PFC) combined with breathing O2 have been shown to have similar effects animal models. We studied an ovine model of severe DCS treated with the intravenous PFC OxycyteTM while breathing O2 compared to saline control also breathing O2. Methods: Juvenile male sheep (N=67; weight 24.4+/2.10kg) were compressed to 257 feet of sea water (fsw) in our multiple large-animal chamber where they remained under pressure for 31 minutes. Animals then were decompressed to surface pressure and randomized to receive either Oxycyte at 5mL/kg intravenously (IV) or 5mL/kg saline IV (both receiving 100% O2) 10 minutes after reaching surface pressure. Mortality was recorded at two hours, four hours, and 24 hours after receiving the study drug. Surviving animals underwent perfusion fixation and harvesting of the spinal cord at 24 hours. Spinal cord sections were assessed for volume of lesion area and compared. Results: There was no significant difference in survival at two hours (p=0.2737), four hours (p=0.2101), or 24 hours (p=0.3171). Paralysis at 24 hours was not significantly different. However, spinal cord lesion area was significantly smaller in the Oxycyte group as compared to the saline group, with median spinal cord lesion areas 0.65% vs. 0.94% (p=0.0107). Conclusions: In this ovine model of severe DCS the intravenous PFC Oxycyte did not reduce mortality but did ameliorate spinal cord injury when used after the onset of DCS.

An 86-year-old man with chronic acid reflux, cryptogenic cirrhosis complicated by hepatic encephalopathy, ascites, and nonbleeding esophageal varices presented to the emergency department with progressive epigastric pain. A portable chest radiograph revealed a 20-mm, disc-like radiopaque foreign body within the middle one-third of the esophagus, which was seen migrating into the gastric fundus 1 hour later on sequential noncontrast abdominal computed tomography imaging (Figure 1). The patient denied foreign-body ingestion, including button battery or coin. Given the history of hepatic encephalopathy and the resemblance of a button battery on imaging, the patient underwent an emergent push upper endoscopy in adherence with guidelines from the American Society for Gastrointestinal Endoscopy on prompt removal of suspicious ingested foreign bodies. 1 The foreign body was not found on endoscopy to the proximal jejunum. After procedure, follow-up radiographs no longer demonstrated the foreign body, and it seemed to have vanished.