BMJ Case Reports 2018; doi:10.1136/bcr-2017-223844
  • Images in…

Hepatic portal venous gas after diving

  1. Taro Shimizu2
  1. 1Department of Emergency Medicine, Okinawa Yaeyama Hospital, Okinawa, Japan
  2. 2Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Tochigi, Japan
  1. Correspondence to Dr Takanobu Hirosawa, t.hirosawa1983{at}
  • Accepted 25 December 2017
  • Published 12 January 2018


A 68-year-old man with diabetes and chronic kidney disease presented with severe epigastric pain and nausea 30 min after scuba diving in Ishigaki Island, southern part of Okinawa Prefecture, Japan. He dived to 10 m (32.8 ft) twice, for an hour each diving. The length of bottom time was unknown. The temperature of the water was 29.0°C (84.2°F). His vital signs were stable. On palpation of abdomen, there was no evidence of guarding and tenderness. There was also no rash. Venous blood gas showed a pH of 7.314 and lactate of 3.03 mmol/L. Other laboratory values were unremarkable, including liver function tests and creatine kinase. An abdominal CT without contrast was performed because he had a …

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article