Diver with decompression injury, elevation of serum transaminase levels, and rhabdomyolysis

A 43-year-old female recreational scuba diver presented to the emergency department 1 hour after a rapid, uncontrolled ascent. Her presentation included progressing confusion, slow and slurred speech, and complaints of headache and hypesthesia over her forearms and anterior thighs bilaterally. Differential diagnosis included arterial gas embolism and decompression sickness. She underwent recompression therapy with US Navy Table 6 within 120 minutes of her ascent. After recompression therapy, the patient had signs and symptoms consistent with severe rhabdomyolysis, including creatine kinase levels of 36,000 U/L and myoglobinuria. [Shank ES, Muth CM. Diver with decompression injury, elevation of serum transaminase levels, and rhabdomyolysis. Ann Emerg Med. May 2001;37:533-536.]