Koutserimpas Christos, Ioannidis Argyrios, Siaperas Petros, Skarpas Andreas, Tellos Andreas, Velimezis Georgios, Karanikas Ioannis
2nd Surgical Department, Sismanoglio General Hospital of Athens, Greece.
Case Rep Emerg Med. 2018 Jun 4;2018:5243105. doi: 10.1155/2018/5243105. eCollection 2018.
Cardiopulmonary resuscitation (CPR) represents an emergency procedure, consisting of chest compressions and artificial ventilation. Two rare cases of intra-abdominal bleeding following cardiac compressions are reported. The first case was a 29-year-old female with massive pulmonary embolism (PE). Following CPR due to cardiac arrest, she showed signs of intra-abdominal bleeding. A liver laceration was found and sutured. The patient passed away, due to massive PE. The second patient was a 62-year-old female, suffering from cardiac arrest due to drowning at sea. CPR was performed in situ. At presentation to the emergency department she showed signs of intra-abdominal bleeding. The origin of the hemorrhage was found to be vessels of the lesser curvature of the stomach, which were ligated. Regarding the first patient PE has already been described as a cause for liver lacerations in CPR due to stasis and liver enlargement. The second case is the first report of gastric vessel injury without gastric rupture/laceration and pneumoperitoneum. Complications of CPR should not represent a drawback to performing cardiac compressions. Parenchymatic injuries have been related to inappropriate technique of chest compressions during basic life support. Therefore, it is of utmost importance for the providers to refresh their knowledge of performing CPR.
心肺复苏术（CPR）是一种急救程序，包括胸外按压和人工通气。本文报告了两例心脏按压后发生腹腔内出血的罕见病例。第一例是一名29岁的女性，患有大面积肺栓塞（PE）。因心脏骤停进行心肺复苏术后，她出现了腹腔内出血的迹象。发现肝脏撕裂并进行了缝合。患者因大面积肺栓塞去世。第二例患者是一名62岁的女性，因在海上溺水导致心脏骤停。在现场进行了心肺复苏术。在急诊科就诊时，她出现了腹腔内出血的迹象。出血的源头被发现是胃小弯处的血管，这些血管被结扎。关于第一例患者，肺栓塞已被描述为心肺复苏术中因淤血和肝脏肿大导致肝脏撕裂的一个原因。第二例是胃血管损伤但无胃破裂/撕裂和气腹的首例报告。心肺复苏术的并发症不应成为进行心脏按压的障碍。实质器官损伤与基础生命支持期间胸外按压技术不当有关。因此，对施救者来说，更新他们进行心肺复苏术的知识至关重要。
