DOI: 10.36347/sjmc8r.2018.v06i07.008

Pages: 468-471

A 52-year-old Japanese diving instructor lost consciousness after 46 minutes of diving at a maximum depth 21 m with decompression performed via a regular decompressive table. He received basic life support, including activation of an automated external defibrillator once. On arrival, he remained in cardiac arrest. The rhythm was asystole. Advanced cardiac life support failed to obtain spontaneous circulation. Whole-body computed tomography (CT) immediately after ceasing resuscitation revealed multiple gas molecules in his body, mainly on the ventral side of the thoracic and abdominal wall in addition to in the right ventricle, the portal vein in the liver, the inferior vena cava, the descending aorta and the spinal canal. However, head CT showed no gas in the brain. This is the second report from Japan describing gas on CT images in a patient with cardiac arrest induced by decompression illness. Off-gassing from the tissue by decompression along with vacuum phenomenon by chest compression are the most likely explanations for the ventral truncal distribution of gases in this patient.