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Gastrointestinal Barotrauma

ByRichard E. Moon, MD, Duke University Medical Center
Diane M. Birnbaumer, MD, David Geffen School of Medicine at UCLA
Reviewed/Revised Jun 2025
View Patient Education

Small amounts of air swallowed while diving may expand during ascent (gastrointestinal barotrauma), usually causing self-limited symptoms.

Divers may inadvertently swallow small amounts of air during a dive. This air expands during ascent, causing abdominal fullness, cramps, pain, belching, and flatulence; these symptoms are self-limited. Gastrointestinal (GI) rupture is rare, manifesting with severe abdominal pain and tenderness with rebound and guarding (1).

If signs of GI rupture are present, immediate upright chest radiograph or CT is performed to detect free air. Milder symptoms require no testing.

Patients with GI rupture require aggressive fluid resuscitation, broad-spectrum antibiotic therapy, and immediate surgical consultation for possible exploratory laparotomy.

More Information

The following English-language resources may be useful. Please note that The Manual is not responsible for the content of these resources.

  1. Divers Alert Network: 24-hour emergency hotline, 919-684-9111

  2. Duke Dive Medicine: Physician-to-physician consultation, 919-684-8111

Reference

  1. 1. Molenat FA, Boussuges AH. Rupture of the stomach complicating diving accidents. Undersea Hyperb Med. 1995;22(1):87-96.

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