Cold injury to a diver's hand after a 90-min dive in 6 degrees C water.

We present here a case of non-freezing cold injury (NFCI) in a sport scuba diver. There are similarities between the presenting symptoms of NFCI and decompression sickness, e.g., pain and/or altered sensation in an extremity, often reported as numbness. In both conditions patients have been known to describe their lower limbs or feet as feeling woolly. Both conditions are the result of environmental exposure. Additionally, there are no good (high sensitivity and specificity) diagnostic tests for either condition. Diagnosis is made based on patient history, clinical presentation, and examination. NFCI is most frequently seen in military personnel, explorers, and the homeless. When affecting the feet of soldiers it is often referred to as "trench foot." Historically, NFCI has been and continues to be of critical importance in infantry warfare in cold and wet environments. A high priority should be given to prevention of NFCI during military operational planning. With the advent of so-called "technical diving" characterized by going deeper for longer (often in cold water) and adventure tourism, this extremely painful condition is likely to increase in prevalence. NFCI is treated symptomatically.

Gastric barotrauma in a scuba diver: report of a case.

Stomach rupture can occur as a consequence of the expansion of compressed air during rapid ascent after diving. We present the case of a middle-aged woman who suffered a gastric tear from surfacing too quickly after diving, and discuss the diagnosis and management of such patients by reviewing previously reported similar events. Gastric barotrauma should be suspected in divers who complain of abdominal pain, even in the absence of frank signs of peritoneal irritation. Although pneumoperitoneum is always present in these patients, it can also occur as a consequence of pulmonary barotrauma, making gastroscopy or radiological contrast studies, or both, essential for a definitive diagnosis. Surgical repair represents the treatment of choice for an active full-thickness tear and, if associated with arterial gas embolism or decompression sickness, should ideally be performed in a center where a category I (intensive care-capable) hyperbaric unit is available.