# Surgical Management for Acute Ischemic Colitis Associated with Decompression Sickness

## TL;DR

A rare case of ischemic colitis leading to bowel necrosis after decompression sickness is reported, highlighting the need for surgical intervention in severe cases.

## Contribution

This case report adds to the limited literature on ischemic colitis associated with decompression sickness and emphasizes the importance of surgical management.

## Key findings

- Ischemic colitis can progress to bowel necrosis in patients with decompression sickness.
- Emergency surgery was necessary to resect necrotic bowel segments in this case.
- Pathological confirmation of ischemic colitis supports its association with decompression sickness.

## Abstract

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.