SCUBA Diving and Portal Vein Thrombosis: A Case Report

Righini, Marc; Gueddi, Salah; Maurel, Boris; Coulange, Mathieu

doi:10.1097/jsm.0b013e3181fab19d

Cited by 7 publications

(8 citation statements)

References 11 publications

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“…One case has been reported of portal venous gas resulting from barotrauma after a rapid ascent. 3 This occurred after having a heavy meal and gaseous drink just before the dive, but the diver also had symptoms of DCS, and the off-gassing process could also explain the portal venous gas. This case is important because the patient developed a portal thrombosis.…”

Section: Discussionmentioning

confidence: 98%

Massive portal venous gas embolism after scuba diving

Siaffa¹,

Luciani²,

Grandjean³

et al. 2019

Diving Hyperb Med

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Portal venous gas from a diving injury is an infrequent finding and only a few cases are described. We report a case of severe decompression sickness (DCS) associated with a massive amount of gas in the portal and mesenteric veins. Case report: A 49-year-old man suffered from DCS after two deep dives on the same day. He presented with cutaneous, neurological and pulmonary symptoms associated with hypoxaemia. He had no abdominal pain. A computed tomography (CT) scan showed large quantities of hepatic and portal venous gas and excluded other explanations for its presence. All symptoms disappeared with hyperbaric oxygen therapy and there were no further complications. Discussion and conclusion: The role of portal venous gas in DCS is not obvious. Isolated portal venous gas seems to cause no obvious harm. Medical imaging should be considered for differential diagnosis and to prevent some complications, especially in divers presenting with abdominal pain.

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Section: Discussionmentioning

confidence: 98%

Massive portal venous gas embolism after scuba diving

Siaffa¹,

Luciani²,

Grandjean³

et al. 2019

Diving Hyperb Med

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“…A case reported in 2010 describes a 49-year-old male diver who reported severe abdominal pain and a pruritic rash immediately after surfacing [ 14 ]. Given the presence of a visible rash consistent with what is known as “skin bends”, a clinical diagnosis of DS was made [ 14 ]. He was recompressed in a hyperbaric chamber as per US Navy Table 5 [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Given the presence of a visible rash consistent with what is known as “skin bends”, a clinical diagnosis of DS was made [ 14 ]. He was recompressed in a hyperbaric chamber as per US Navy Table 5 [ 14 ]. His symptoms initially resolved; however, epigastric pain developed shortly thereafter [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

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Portal and Mesenteric Vein Thrombosis Associated with Decompression Sickness in a 48-Year-Old Deep Sea Self-Contained Underwater Breathing Apparatus (SCUBA) Diver

et al. 2022

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Patient: Male, 48-year-old Final Diagnosis: Mesenteric vein thrombosis • portal vein thrombosis Symptoms: Abdominal pain • nausea Medication: — Clinical Procedure: — Specialty: Gastroenterology and Hepatology • Hematology • General and Internal Medicine • Sports Medicine Objective: Unusual clinical course Background: Deep sea diving can cause decompression illness which comprises both decompression sickness and arterial gas embolism. Decompression sickness is a clinical diagnosis with symptoms including dizziness, joint pain, rash, and myalgias and is due to nitrogen bubbles that form in tissues during ascent. These gas bubbles can be clinically silent even in the absence of decompression sickness and can rarely predispose a patient to venous thrombus, for which the role of hyperbaric oxygen (HBO) is undefined. The following case describes a male diver who developed portal and mesenteric venous thrombosis secondary to silent nitrogen venous bubbles. Case Report: A 48-year-old man developed abdominal pain 1 day after diving to a maximum depth of 13.7 m, without clinical symptoms of decompression sickness after surfacing. He presented to the Emergency Department 10 days later, and magnetic resonance angiogram revealed a diagnosis of gas containing superior mesenteric and portal vein thrombus. Due to the lack of guidelines of HBO with the presence of a thrombus and timing since onset, HBO therapy was not pursued. Oral anticoagulation was initiated, and symptoms resolved. Conclusions: This patient developed gastrointestinal illness 1 day after diving that was later found to be due to thrombosis. Other etiologies were ruled out, making silent nitrogen bubbles within the venous system the most likely etiology. Vascular thrombosis is a rare complication of diving and lacks guidelines for treatment. While HBO is a known treatment for decompression sickness, there are no clinical guidelines for diving-associated thrombi, representing an area for further research.

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“…PVT most commonly occurs in patients with liver cirrhosis, intraabdominal malignancy (especially hepatocellular carcinoma), intraabdominal infection (pylephlebitis and liver abscess), inherited or acquired prothrombotic disorders, MPN, or autoimmune diseases and rarely in nephrotic syndrome. Sport-related trauma leading to PVT is rare with only two cases reported in literature, one in scuba diver and another in rugby player [ 9 , 10 ]. The proposed mechanisms by which these sports-related injuries cause PVT are most likely related to local endothelial damage to veins of abdominal wall and periportal hematoma formation with subsequent stasis in portal vein leading to thrombus formation [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Sport-Related Portal Vein Thrombosis: An Unusual Complication

Dumić

Tankosic

Lalosevic

et al. 2017

Case Reports in Hepatology

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Portal vein thrombosis (PVT) is an uncommon condition usually associated with hypercoagulable states or liver cirrhosis. PVT due to sports-related injuries is rarely reported and, to the best of our knowledge, only two cases have been reported thus far. Brazilian jiu-jitsu (BJJ) is a form of martial arts and is considered very safe with minimal risk for injury. It has growing popularity worldwide. Here, we report the first case of PVT secondary to abdominal trauma related to the practice of (BJJ) in an otherwise healthy 32-year-old man with no other traditional risk factors for PVT.

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SCUBA Diving and Portal Vein Thrombosis: A Case Report

Cited by 7 publications

References 11 publications

Massive portal venous gas embolism after scuba diving

Massive portal venous gas embolism after scuba diving

Portal and Mesenteric Vein Thrombosis Associated with Decompression Sickness in a 48-Year-Old Deep Sea Self-Contained Underwater Breathing Apparatus (SCUBA) Diver

Sport-Related Portal Vein Thrombosis: An Unusual Complication

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