TL;DR: Is it possible to have subcutaneous emphysema after diving without any other form of lung barotrauma?
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Hi!
I had an accident during a recent dive trip in Cozumel and I am desperate to know if I can ever dive safely again.
- Day 1 of the trip: After our first dive (60mins, max depth 18m), I scratched my forehead and happened to palpate subcutaneous emphysema (I am 100% sure it was that, I work in an ER). It was also present on my neck. I don't recall palpating my chest. I felt completely fine otherwise, so I decided to go for the second dive and everything went well. I still had the emphysema after the second dive but it went away in about 30 minutes. I don't recall anything that could have happened during the first dive to explain this (ie. Fast ascent, breath-holding).
- Day 2: no diving
- Day 3: I did 4 dives that day. I had emphysema after the first dive. By the end of the 4th dive, it was present on my face, neck, upper chest and both arms, up to the hands. Again, no other symptoms at that moment and it went away in about 60 minutes. It was only when I was lying in my bed in the evening that I started to feel some mild, non pleuretic, retrosternal chest pain radiating to my back, but it seemed pretty non specific to me (it could have felt like muscle pain).
- Day 4: As I had to fly home the next day, I finally decided to get checked up. I got a thoracic CT (15 hours after the last dive), which came back normal. I was asymptomatic at that time. After getting discharged from the hospital that same day, I went for a swim in the sea and a small amount of emphysema came back on my neck.
Both the Mexican dive doctor and the one I saw back home found this very strange, especially as the CT came back completely normal. I am not known for any lung disease either. To me, it seems a bit unlikely that a pneumomediastinum or pneumothorax would have caused the emphysema because, to my knowledge, these findings do not resolve as fast on imagery. Therefore, I am wondering if anyone has experienced or seen a similar case? Can subcutaneous emphysema be an entity on its own? Would it be a contraindication to diving?
Thank you!!
_________
Hi!
I had an accident during a recent dive trip in Cozumel and I am desperate to know if I can ever dive safely again.
- Day 1 of the trip: After our first dive (60mins, max depth 18m), I scratched my forehead and happened to palpate subcutaneous emphysema (I am 100% sure it was that, I work in an ER). It was also present on my neck. I don't recall palpating my chest. I felt completely fine otherwise, so I decided to go for the second dive and everything went well. I still had the emphysema after the second dive but it went away in about 30 minutes. I don't recall anything that could have happened during the first dive to explain this (ie. Fast ascent, breath-holding).
- Day 2: no diving
- Day 3: I did 4 dives that day. I had emphysema after the first dive. By the end of the 4th dive, it was present on my face, neck, upper chest and both arms, up to the hands. Again, no other symptoms at that moment and it went away in about 60 minutes. It was only when I was lying in my bed in the evening that I started to feel some mild, non pleuretic, retrosternal chest pain radiating to my back, but it seemed pretty non specific to me (it could have felt like muscle pain).
- Day 4: As I had to fly home the next day, I finally decided to get checked up. I got a thoracic CT (15 hours after the last dive), which came back normal. I was asymptomatic at that time. After getting discharged from the hospital that same day, I went for a swim in the sea and a small amount of emphysema came back on my neck.
Both the Mexican dive doctor and the one I saw back home found this very strange, especially as the CT came back completely normal. I am not known for any lung disease either. To me, it seems a bit unlikely that a pneumomediastinum or pneumothorax would have caused the emphysema because, to my knowledge, these findings do not resolve as fast on imagery. Therefore, I am wondering if anyone has experienced or seen a similar case? Can subcutaneous emphysema be an entity on its own? Would it be a contraindication to diving?
Thank you!!