Cases from the Aerospace Medicine Resident's Teaching File: unsuspected pulmonary barotrauma

A USAF pararescue specialist developed chest pain during scuba diving duty. Initial evaluations considered decompression sickness and musculoskeletal etiologies. Pulmonary barotrauma was not contemplated because of the relatively mild presentation. Later, a very significant pneumothorax was discovered and successfully treated without sequelae. Decompression sickness is briefly discussed followed by a more in-depth examination of the presentation, diagnosis, treatment, and aeromedical aspects of spontaneous and "deserved" pneumothoraces.