Fatal diving: could it be an immersion pulmonary edema? Case report.

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Serval ID
serval:BIB_0A3EC9298586
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Fatal diving: could it be an immersion pulmonary edema? Case report.
Journal
International journal of legal medicine
Author(s)
Evain F., Louge P., Pignel R., Fracasso T., Rouyer F.
ISSN
1437-1596 (Electronic)
ISSN-L
0937-9827
Publication state
Published
Issued date
05/2022
Peer-reviewed
Oui
Volume
136
Number
3
Pages
713-717
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Abstract
Immersion pulmonary edema is a rare, underrecognized, and potentially lethal pathology developing during scuba diving and other immersion-related activities (swimming or apnoea). Physiopathology is complex and not fully understood, but its mechanisms involve an alteration of the alveolo-capillary barrier caused by transcapillary pressure elevation during immersion, leading to an accumulation of fluid and blood in the alveolar space. Diagnosis remains a challenge for clinicians and forensic practionner. The symptoms begin during ascent, with cough, frothy sputum, and hemoptysis. Auscultation reveals signs of pulmonary edema. Pulmonary CT scan, which is the radiological exam of choice, shows ground glass opacities and interlobular thickening, eventually demonstrating a patterned distribution, likely in the anterior segments of both lungs. Apart from the support of vital functions, there is no specific treatment and hyperbaric oxygen therapy is not systematically recommended. We present a case of fatal IPE occurring in a recreational diver who unfortunately died shortly after his last dive. Diagnosis was made after complete forensic investigations including post-mortem-computed tomography, complete forensic autopsy, histological examination, and toxicological analysis.
Keywords
Diving/adverse effects, Humans, Immersion/adverse effects, Lung/diagnostic imaging, Lung/pathology, Pulmonary Edema/diagnostic imaging, Pulmonary Edema/pathology, Swimming, Autopsy, Case report, Diving, Edema, Pulmonary
Pubmed
Web of science
Open Access
Yes
Create date
13/12/2022 14:39
Last modification date
25/01/2024 8:31
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