Decompression syndrome (Caisson disease) in an Indian diver

Abstract

Acute decompression syndrome (Caisson’s disease) is an acute neurological emergency in divers. It is caused due to release of nitrogen gas bubbles that impinge the blood vessels of the spinal cord and brain and result in severe neurodeficit. There are very few case reports in Indian literature. There are multiple factors in the pathogenesis of Acute decompression syndrome (Caisson’s disease) such as health problems in divers (respiratory problems or congenital heart diseases like atrial septal defect, patent ductus arteriosus etc), speed of ascent from the depth and habits like smoking that render divers susceptible for such neurological emergency. Usually, immediate diagnosis of such a condition with MRI is not possible in hospitals in the Coastal border. Even though, MRI is performed, it has very low specificity and sensitivity. Facilities like hyperbaric oxygen treatment are virtually non-existent in these hospitals. Therefore, proper education of the divers and appropriate preventive measures in professional or recreational divers is recommended.

Hypovolemia in Extracorporeal Life Support Can Lead to Arterial Gaseous Microemboli

“…Henry's law states that the amount of gas that dissolves in liquid is directly proportional to the partial pressure of that gas within that liquid . Moreover, both partial gas pressure and gas solubility are affected by hydrostatic pressure , as seen in divers suffering from a decompression syndrome . Applied to ELS, this means that hypovolemia and resultant subatmospheric venous line pressure may locally provoke degassing of blood‐dissolved gasses and gaseous microemboli (GME) .…”

Short Update on Dysbaric Osteonecrosis: Concepts and Decompression Management

“…Other causes of aseptic bone necrosis being ruled out, lesions specific to DON can take months to develop 1,17,21,[23][24][25][26] . Almost all cases of DCS (including prospective cases of DON) invariably report pain, the 'bends', at their shoulders and /or hips more frequently than other joints 6,19,27 . There are more than a few variables that link DCS to DON and the correlation between these two conditions is controversial 1 .…”

“…The role of lipid dissolution D deep-sea diving or are exposed to environments of high air pressures [1][2][3][4][5] . Dysbarism or Caisson Disease (CD) is characterized by an array of systemic complications involving soft tissues, the cardio-pulmonary, nervous, renal and musculoskeletal systems when individuals or experimental animals are brought back to normal atmospheric pressures without adequate decompression, even after a single hyperbaric exposure 1,6,7 . Dysbaric osteonecrosis (DON), one of the primary constituents of DCS, has been a subject of prolonged investigations to determine the precise patho-physiology of the affliction, and its prevalence and relationship with DCS.…”

Decompression sickness in an Indian diver

“…We read with extreme interest the case report ‘Decompression Sickness (Caisson Disease) in an Indian Diver’[ 1 ] and the Letter to Editor titled ‘Decompression Syndrome, ear – plug and barotrauma’. [ 2 ] We wish to congratulate the authors for highlighting extremely pertinent issues related to this occupational hazard of divers and aviators.…”