Surgical Management for Acute Ischemic Colitis Associated with Decompression Sickness

Ischemic colitis secondary to decompression sickness (DCS) is rare. Here, we present a case of ischemic colitis resulting in bowel necrosis following DCS.

A 63-year-old male, with a history of hyperbaric oxygen (HBO) therapy for DCS 6 years ago, presented with limb and lower abdominal pain after a 55-m dive. The patient was diagnosed with DCS, and HBO therapy was initiated. However, due to worsening lower abdominal pain, contrast-enhanced computed tomography was performed on the second day. Imaging revealed a poorly enhanced segment extending from the rectum to sigmoid colon suggestive of bowel necrosis. Emergency surgery was performed, and the necrotic bowel segments were resected, followed by a descending colostomy. Pathological examination revealed ischemic colitis.

Ischemic colitis should be considered a differential diagnosis in patients with DCS presenting with abdominal symptoms. Surgical intervention may be required in patients with recurrent DCS, depending on the patient's condition.