Gastrointestinal Barotrauma

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

(See also Overview of Diving Injuries and Overview of Barotrauma.)

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 rarely occurs, manifesting with severe abdominal pain and tenderness with rebound and guarding.

If signs of GI rupture are present, immediate upright chest x-ray or CT is done 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.