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BMJ Case Reports 2018; doi:10.1136/bcr-2017-223844
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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}gmail.com
  • Accepted 25 December 2017
  • Published 12 January 2018

Description

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 …

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