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A diver's dilemma - a case report on bronchopulmonary sequestration
Timothy Xin Zhong Tan1, Andrew Yunkai Li2, James Jie Sng3
1Navy Medical Service, Republic of Singapore Navy, 126 Tanah Merah Coast Road, Singapore, 498822, Singapore. timothy.tbj13@gmail.com.
BMC Pulmonary Medicine
|May 6, 2020
Summary
A SCUBA diver diagnosed with a congenital lung condition, intralobar bronchopulmonary sequestration, raises concerns for diving fitness. This case highlights the need for updated guidelines regarding diving with such conditions.
Area of Science:
- Pulmonology
- Diving Medicine
- Radiology
Background:
- A SCUBA diver with no prior symptoms or diving complications was diagnosed with intralobar bronchopulmonary sequestration.
- This congenital lung condition was discovered during routine screening for an overseas naval diving course.
- There is a lack of existing literature addressing the diving fitness of individuals with bronchopulmonary sequestration.
Observation:
- The diver, a 26-year-old male, had previously completed numerous military and recreational dives.
- Pre-course screening revealed a left lower lobe pulmonary nodule, diagnosed as intralobar bronchopulmonary sequestration via CT scan.
- The diver remained asymptomatic and was cleared for dry hyperbaric chamber diving without surgery.
Findings:
- Intralobar bronchopulmonary sequestrations, despite lacking direct tracheobronchial communication, may harbor air pockets.
- Anomalous connections can lead to air entrapment, increasing the risk of pulmonary barotrauma during diving.
- Potential complications include pneumothorax, pneumomediastinum, and cerebral arterial gas embolism.
Implications:
- Bronchopulmonary sequestrations are currently considered contraindications for diving due to theoretical risks.
- Air-containing lung lesions necessitate careful evaluation for diving suitability.
- Surgical resection of bronchopulmonary sequestration may allow individuals to be considered fit for diving.
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