A 63-year-old woman was transferred to our ICU after suffering a cardiac arrest following a diving accident. Her condition was unstable. A CT revealed air embolisms in the pulmonary artery and right atrium; intestinal pneumatosis and pneumoperitoneum and presence of portal air (Fig. 1a, b). An exploratory laparotomy revealed no evidence of pathology. Because of the persistent haemodynamic instability, it was not possible to transfer the patient to a centre with a hyperbaric chamber. She continued to be treated properly; however, she remained in a state of refractory shock, organ failure and finally died 24 h later. The final diagnosis was air embolism secondary to severe decompression sickness.
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