Gastrointestinal Barotrauma

ByRichard E. Moon, MD, Duke University Medical Center
Reviewed/Revised Apr 2023
View Patient Education

Small amounts of air swallowed when diving may expand during ascent (gastrointestinal barotrauma), usually causing self-limited symptoms.

(See also Overview of Diving Injuries and Overview of Barotrauma.)

Divers may inadvertently swallow small amounts of air during a dive. This air expands during ascent, causing abdominal fullness, cramps, pain, belching, and flatulence; these symptoms are self-limited. Gastrointestinal (GI) rupture rarely occurs, manifesting with severe abdominal pain and tenderness with rebound and guarding.

If signs of GI rupture are present, immediate upright chest x-ray or CT is done to detect free air. Milder symptoms require no testing.

Patients with GI rupture require aggressive fluid resuscitation, broad-spectrum antibiotic therapy, and immediate surgical consultation for possible exploratory laparotomy.

More Information

The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.

  1. Divers Alert Network: 24-hour emergency hotline, 919-684-9111

  2. Duke Dive Medicine: Physician-to-physician consultation, 919-684-8111

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