Description

ABSTRACT

Özkan R, Kaya B. High-Altitude Decompression Illness Following Recreational Diving: A Case

Report from Lake Van. Undersea Hyperb Med. 2026 First Quarter; 53(1):31-34.

Rationale: Decompression sickness (DCS) is a clinical syndrome caused by inert gas bubble formation

following a rapid reduction in ambient pressure, with an increased risk in high-altitude diving due

to lower barometric pressure. Although neurological symptoms are well-documented, respiratory

involvement is less frequently reported.

Patient Presentation: A 54-year-old male recreational diver performed his first-ever dive in Lake Van,

descending to approximately 30 meters and remaining at depth for several minutes before ascending

rapidly to the surface without a decompression stop. Immediately after surfacing, he experienced sudden

weakness in both legs and shortness of breath. He aspirated water and recalled calling for help before

losing awareness. Located approximately 300 meters from shore, he was towed back by his dive team.

Finding no pulse, the team initiated CPR and rescue breathing.

Upon arrival, emergency medical services found the patient with spontaneous respiration and a palpable

pulse. Within 30 minutes, he was transported approximately 16 kilometers to the nearest hospital. High-

flow oxygen treatment via a non-rebreather mask was initiated, and he was transferred to the emergency

department.

In the emergency department, the patient stated he remembered seeing lights but could not recall the

intervening events. Due to neurological deficits and suspected DCS, he was immediately referred to a

hyperbaric unit. A single hyperbaric oxygen (HBO2) treatment session was administered according to

the US Navy Table 5 protocol, resulting in marked symptom resolution. The patient was transferred from

intensive care to the general ward and discharged at his request after declining further HBO2 sessions.

Conclusion: This case underscores the risk of high-altitude DCS and highlights the importance of

altitude-specific dive planning and timely HBO2 intervention. Increased awareness among recreational

divers is essential to prevent such complications.

Keywords: decompression sickness; high-altitude diving; hyperbaric oxygen treatment; neurological DCS;

Lake Van

DOI: 10.22462/885