Dias Lucas Teixeira, Mendes Lucas Cronemberger Maia, Mello Patrícia Machado Veiga de Carvalho, Santos Lina Gomes, Vasconcelos Jayro Tadeu Paiva de
Universidade Federal do Piauí.
Hospital São Marcos.
Rev Bras Ter Intensiva. 2006 Jun;18(2):207-11.
Gastric rupture is a rare complication from cardiopulmonary resuscitation (CPR), with a reported incidence of 0.1%. Unawareness of this possible complication during these maneuvers delays its recognition and reduces the patients surviving chance. The aim of this report is to describe a case of acute abdomen due to gastric rupture following CPR maneuvers that was promptly diagnosed and treated.
We report a case of a 76-year-old patient that was admitted to the hospital with pneumonia and also to rule out a possible brain vascular accident (BVA). In the first day after admission she developed acute respiratory failure and cardiac arrest, being successfully resuscitated and subsequently transferred to the intensive care unit (ICU) by the medical ward team. Despite successful CPR, adequate volume resuscitation, vasopressor support and respiratory function improvement she remained with significant hemodynamic instability. Physical examination hours after CPR showed a hypertimpanic liver percussion, abdominal distension, tachycardia and hypotension. Chest X-Ray revealed pneumoperitoneum, and gastric perforation was identified by an exploratory laparotomy. Histopathology confirmed traumatic gastric injury.
We report a rare case of traumatic gastric rupture after CPR maneuvers in which prompt diagnosis and emergent treatment lead to a favorable outcome. This case brings out the need to increase awareness of this life-threatening complication with emphasis on the importance of a thorough physical examination after CPR maneuvers. Reinforcement of appropriate CPR technique is crucial to avoid incorrect maneuvers through continued medical education.
胃破裂是心肺复苏（CPR）罕见的并发症，报道的发生率为0.1%。在这些操作过程中未意识到这种可能的并发症会延迟其识别并降低患者的存活几率。本报告的目的是描述一例因心肺复苏操作后胃破裂导致的急腹症病例，该病例得到了及时诊断和治疗。
我们报告一例76岁患者，因肺炎入院，同时排除可能的脑血管意外（BVA）。入院后第一天，她出现急性呼吸衰竭和心脏骤停，经成功复苏后，随后由内科病房团队转入重症监护病房（ICU）。尽管心肺复苏成功、液体复苏充分、血管活性药物支持及呼吸功能改善，但她仍存在明显的血流动力学不稳定。心肺复苏数小时后的体格检查显示肝脏叩诊呈鼓音、腹胀、心动过速和低血压。胸部X线显示气腹，经剖腹探查确定为胃穿孔。组织病理学证实为外伤性胃损伤。
我们报告一例心肺复苏操作后外伤性胃破裂的罕见病例，及时诊断和紧急治疗带来了良好的结果。该病例凸显了提高对这种危及生命并发症的认识的必要性，强调了心肺复苏操作后全面体格检查的重要性。通过持续医学教育强化适当的心肺复苏技术对于避免错误操作至关重要。
