Chest
Volume 87, Issue 2, February 1985, Pages 264-265
Journal home page for Chest

Diving and Chronic Spontaneous Pneumothorax

https://doi.org/10.1378/chest.87.2.264Get rights and content

Diving and pneumothorax cannot go together. An air bubble between the visceral and the parietal pleura will change its size according to Boyle's law, and pneumothorax might increase in size during the ascent from a dive. We would like to present the case of a professional diver, who was engaged in active diving for a period of five months during which time he made 80 to 85 dives with pneumothorax. As far as we know, this is the first such case published in the medical literature. We should also like to emphasize the protracted nature of the pneumothorax, which persisted for that time without changing size. This diver had no medical problems with diving, and the deeper he descended, the better he felt. No tension pneumothorax ever occurred and the diagnosis was made by chance.

Section snippets

CASE REPORT

This diver is a 28-year-old white man, athletic, 178 cm tall, and weighing 76 kg. His medical history is unremarkable, as is his family's. He has been a diving instructor for ten years. Normally, he does not smoke.

However, on the evening of February 20, 1983, he tried to smoke a large cigar. Immediately after the first puff, he coughed heavily, after which he felt a moderate pain in the midchest. From February 21 to March 27, he made about two dives a day. But the pain in his chest persisted

DISCUSSION

A history of spontaneous pneumothorax is a contraindication for diving.2,3 Most of these patients suffer from pulmonary pathology, usually subpleural emphysematous blebs or bullae.4 The recurrence rate is high: 33 percent in five years according to Edmonds et al,5 an average of 20 percent to 30 percent according to Kizer3 or 50 percent according to Saunders and Ingram.6 This high recurrence rate is the main reason for prohibiting further diving. The possibility of diving after traumatic

REFERENCES (9)

  • D.D. Hickey

    Outline of medical standards for divers. Hyperbaric research laboratory

    (1981)
  • J.C. Davis et al.

    Selection of divers: examination and physical standards

  • K.W. Kizer

    Spontaneous pneumothorax and diving

    Pressure

    (1982)
  • N. Ohata et al.

    Pathogenesis of spontaneous pneumothorax

    Chest

    (1980)
There are more references available in the full text version of this article.

Cited by (22)

  • Spontaneous Pneumothorax

    2021, Encyclopedia of Respiratory Medicine, Second Edition
  • Influence of atmospheric pressure, outdoor temperature, and weather phases on the onset of spontaneous pneumothorax

    2005, Annals of Epidemiology
    Citation Excerpt :

    Once this communication is disrupted, these cysts become isolated from the surrounding lung tissue, changing their morphology according to Boyle-Marriott's law (P × V = const.), i.e., a fall in AP causes an increase in their volume (1). Although the morphology and ultrastructure of causative lesions in primary SP are well known, the reason for rupture of air-containing cysts is not absolutely clear (2).

  • Pneumothorax and pneumomediastinum

    2004, Clinics in Sports Medicine
View all citing articles on Scopus
View full text