DOI: 10.363247/sjmcr.2018.v06i10.026

Pages: 838-839

A 36-year-old woman performed a 20-m free dive with fins. She felt dyspnea and developed a cough after the fourth free dive. She grew pale, so an ambulance was called. When emergency medical technicians checked the patient, the percutaneous saturation of oxygen was approximately 70%, so she received 10 L/minute of oxygen with a reservoir face mask. She also had hemoptysis. On arrival at our hospital, chest roentgen revealed bilateral cloudy lung fields. The findings on an electrocardiogram were negative. Cardiac ultrasound findings showed a good wall motion and were negative for gas. Thoracic computed tomography (CT) revealed a bilateral diffuse ground-glass appearance. She was admitted to the hospital with oxygen therapy, and her respiratory function dramatically improved. On the third day, she was discharged without sequalae. This is a rare case report showing alveolar hemorrhaging after free diving. The differential diagnosis with decompression sickness may be facilitated by a thorough review of the diving profile and an investigation of the gas bubbles using ultrasound. Physicians may encounter patients with pulmonary barotrauma regardless of practice location and should be familiar with its clinical manifestations and treatment.