Postflight Pulmonary Barotrauma in a Pilot Without Underlying Disease
BACKGROUND: Exposure to pressure changes can result in barotrauma in gas-filled cavities when volume expansion exceeds tissue strength, leading to local disruption. While few cases have been reported, we present a case of pulmonary barotrauma developed postflight in a pilot without underlying disease, and the most likely reason is improper pressure-breathing in flight. CASE REPORT: A 25-yr-old healthy male fighter pilot experienced slight chest pain 3 h after a 1-h flight training mission, during which the peak G was 6 G. The symptoms worsened during eating and were accompanied by chest tightness and shortness of breath. Chest CT scans showed pneumothorax and mediastinal emphysema. Symptoms improved after oxygen inhalation and the pilot resumed flying duties (no high-G dynamic flight maneuvers) after 1 mo of observation on the ground. DISCUSSION: The case revealed pulmonary barotrauma in an experienced pilot with no disease history due to inappropriate positive pressure-breathing, suggesting the importance of fully training in positive pressure-breathing for G. We recommend pilots who experience unusual respiratory symptoms after landing report to medical for urgent review and the flight surgeon should, at that time, consider flight-related factors leading to barotrauma. Meng W, Zhou Q, Qing L. Postflight pulmonary barotrauma in a pilot without underlying disease. Aerosp Med Hum Perform. 2025; 96(7):578–580.
Lung window of 128-slice (B and C) or 640-slice (A and D) chest CT revealing pneumothorax and mediastinal emphysema postflight. The last chest CT during an annual check-up was completely normal prior to this incident. A) Emergency chest CT examination showed B) pneumothorax and mediastinal emphysema, which C) improved 4 d later and D) showed full recovery after 1 mo; pneumothorax is marked by light arrows, and mediastinal emphysema is marked by bold arrows in B and C.
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