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

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 ba...

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Autores principales: Evain, France, Louge, Pierre, Pignel, Rodrigue, Fracasso, Tony, Rouyer, Frédéric
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9005437/
https://www.ncbi.nlm.nih.gov/pubmed/35284967
http://dx.doi.org/10.1007/s00414-022-02809-x
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author Evain, France
Louge, Pierre
Pignel, Rodrigue
Fracasso, Tony
Rouyer, Frédéric
author_facet Evain, France
Louge, Pierre
Pignel, Rodrigue
Fracasso, Tony
Rouyer, Frédéric
author_sort Evain, France
collection PubMed
description 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.
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spelling pubmed-90054372022-04-14 Fatal diving: could it be an immersion pulmonary edema? Case report Evain, France Louge, Pierre Pignel, Rodrigue Fracasso, Tony Rouyer, Frédéric Int J Legal Med Case Report 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. Springer Berlin Heidelberg 2022-03-14 2022 /pmc/articles/PMC9005437/ /pubmed/35284967 http://dx.doi.org/10.1007/s00414-022-02809-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Case Report
Evain, France
Louge, Pierre
Pignel, Rodrigue
Fracasso, Tony
Rouyer, Frédéric
Fatal diving: could it be an immersion pulmonary edema? Case report
title Fatal diving: could it be an immersion pulmonary edema? Case report
title_full Fatal diving: could it be an immersion pulmonary edema? Case report
title_fullStr Fatal diving: could it be an immersion pulmonary edema? Case report
title_full_unstemmed Fatal diving: could it be an immersion pulmonary edema? Case report
title_short Fatal diving: could it be an immersion pulmonary edema? Case report
title_sort fatal diving: could it be an immersion pulmonary edema? case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9005437/
https://www.ncbi.nlm.nih.gov/pubmed/35284967
http://dx.doi.org/10.1007/s00414-022-02809-x
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