Cases reported "barotrauma"

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1/160. Hypobaric ocular trauma from a Popper.

    We have observed 3 cases of ocular trauma in children that were caused by an atypical, hypobaric mechanism induced by a toy called a Popper. When we initially notified the united states consumer product safety Commission in 1990, Poppers disappeared from store shelves. We are concerned that this potentially harmful toy is making a comeback in 1998 (Smilemakers Inc, Spartanburg, SC; June-July 1998 catalog, p. 57). In 1990, packaged poppers cautioned against applying to face or skin; we are not sure that such warnings accompany current Poppers. ( info)

2/160. Successful use of high frequency oscillatory ventilation for pneumomediastinum.

    An infant with pneumomediastinum due to mechanical ventilation was successfully treated using high frequency oscillatory ventilation (HFOV). The 3-month-old male had undergone ligation of a patent ductus arteriosus and suffered from barotraumatic pneumomediastinum in the postoperative period. Computed tomography of the chest confirmed the diagnosis. While using conventional mechanical ventilation the respiratory failure worsened. HFOV was instituted and the patient improved. A lower airway pressure by this mode of ventilation provided significant advantages in the patient with an air leak. He was subsequently extubated and discharged home. ( info)

3/160. Inner ear barotrauma from scuba diving.

    Inner ear barotrauma among scuba divers is believed to be caused by any of three conditions: a hemorrhage in the inner ear, a tear of the labyrinthine membrane, or a perilymphatic fistula. These injuries may occur concurrently or separately. hemorrhage and membrane rupture are managed conservatively, while fistula requires surgical repair. In this report, we describe three cases of inner ear barotrauma in scuba divers. We also discuss the proposed etiologies of this injury and the controversy over whether or not divers who have suffered an inner ear trauma can safely resume scuba diving. Although the older literature clearly suggests otherwise, we believe that scuba divers who completely recover from inner (or middle) ear barotrauma may return to diving as long as they exercise caution and care. ( info)

4/160. Infraorbital hypesthesia after maxillary sinus barotrauma.

    We report a case of a diver who suffered an episode of maxillary sinus barotrauma that presented with decreased sensation over the cutaneous distribution of the infraorbital nerve after an ascent which produced facial pain and crepitus. This case illustrates a potential confusion between a decompression sickness etiology and a barotraumatic etiology for the observed sensory deficit. The clinical features of this case were most consistent with a barotraumatic etiology for the findings noted. The anatomy of the trigeminal nerve and previous reports of cranial nerve deficits following barotrauma are reviewed. ( info)

5/160. Pulmonary cyst and cerebral arterial gas embolism in a hypobaric chamber: a case report.

    This is a report of an aircrew member who suffered a serious physiological incident in the form of pulmonary barotrauma and cerebral arterial gas embolism during hypobaric chamber training, and who subsequently was shown to have a cyst in the upper lobe of the left lung. The likely origin of the cyst is discussed, as well as the aeromedical disposition following thoracotomy and apical segmentectomy to remove the cyst. ( info)

6/160. A case of barotrauma-induced pneumolabyrinth secondary to perilymphatic fistula.

    We report the case of a 62-year-old woman who experienced pneumolabyrinth associated with a perilymphatic fistula. Her condition was diagnosed with the help of computed tomography, which detected the presence of an air bubble in the labyrinth, and middle ear exploration, which revealed that clear fluid was emanating from the round window niche in a manner consistent with the presence of a perilymphatic fistula. The niche was repaired with tragal perichondrium and bolstered with Gelfoam. ( info)

7/160. The role of computed tomography in the diagnosis of arterial gas embolism in fatal diving accidents in tasmania.

    Four cases of fatal diving accidents in tasmania are presented, highlighting the role of CT in the investigation of diving fatalities. The CT technique allows rapid diagnosis when arterial gas embolism (AGE) is suspected. The traditional method of investigation, underwater autopsy, is a difficult procedure that requires specialized training in which the subtle diagnosis of AGE may be completely missed. Facilities for performing underwater autopsies are normally available only in tertiary referral centres, and therefore the diagnosis of AGE may be missed due to lack of facilities. The use of CT in the diagnosis of AGE in divers was first utilized in the early 1980s but has still not become widely adopted in forensic practice. This radiological technique has the advantage of being sensitive, quick, reliable, readily available and provides a permanent record. For hospitals that do not have a resident forensic pathologist, a CT scan can be easily performed and interpreted to eliminate the possibility of AGE. There are a number of pitfalls in the diagnosis of AGE with CT, particularly intravascular gas production following postmortem fermentation and off-gassing. awareness of these pitfalls will help the radiologist in making a correct diagnosis of AGE. ( info)

8/160. Neurological consequences of scuba diving with chronic sinusitis.

    Sinus barotrauma from scuba diving is relatively common, usually self-limiting, and often the result of transient nasal pathology. We describe serious neurological sequelae occurring in two scuba divers who had chronic sinusitis We suggest guidelines for evaluating and treating divers who have chronic sinusitis. Divers with nasal or sinus pathology should be aware of the potentially serious consequences associated with scuba diving even after endoscopic sinus surgery to correct this condition. ( info)

9/160. Delayed onset pulmonary barotrauma or decompression sickness? A case report of decompression-related disorder.

    A-24-yr-old male professional diver began to complain of substernal pain 3 h after a controlled ascent from a dive of less than 40 ft of sea water (fsw). The diving master who supervised his dive and the physicians who examined him on presentation suspected pulmonary barotrauma rather than decompression sickness (DCS) because he had only descended to a depth of 32 fsw. Hyperbaric oxygen therapy (HBO) by U.S. Navy treatment Table VI was implemented because of his progressively worsening pain. HBO was apparently effective and a relapse was not seen. The author cannot label his condition based on the conventional classification categories, such as decompression sickness (DCS), barotrauma or even decompression illness. This case report is offered as a topic for consideration in the controversy over decompression-related disorders. ( info)

10/160. Acute confusion secondary to pneumocephalus in an elderly patient.

    PRESENTATION: an 83-year-old man was admitted to hospital with acute confusion 3 days after a direct flight from australia. OUTCOME: computed tomography (CT) brain scan and magnetic resonance imaging head scan revealed the cause to be pneumocephalus, apparently the result of barotrauma caused by Valsalva manoeuvres when he attempted to unblock his nose during the flight. After 5 days of nursing in the vertical position the patient's Abbreviated Mental Score returned to normal. A CT brain scan 6 weeks later showed complete resolution of the pneumocephalus. ( info)
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