TY - JOUR
T1 - Traumatic liver injury caused by cardiopulmonary resuscitation using an automated sternal compression device that was successfully treated by direct surgical ligation
AU - Hayakawa, Shunsuke
AU - Miyai, Hirotaka
AU - Watanabe, Kawori
AU - Fujihata, Shiro
AU - Yasuda, Akira
AU - Yamamoto, Minoru
AU - Kitagami, Hidehiko
AU - Shimizu, Yasunobu
AU - Hayakawa, Tetsushi
AU - Tanaka, Moritsugu
N1 - Publisher Copyright:
© 2017 The Japanese Society of Gastroenterological Surgery.
PY - 2017
Y1 - 2017
N2 - A 69-year-old man presented to a neighborhood hospital complaining of malaise, and while being examined, developed cardiopulmonary arrest. Cardiopulmonary resuscitation was then carried out using an automated sternal compression device. Thereafter, he was rushed to our hospital, where emergency coronary arteriography was performed after a clinical diagnosis of acute myocardial infarction was made. Coronary revascularization was accomplished by thrombus aspiration, stent placement, and anticoagulant therapy. While the clinical course was uneventful in the initial period after admission to the intensive care unit (ICU), the patient developed circulatory shock of sudden onset at 6 hours after ICU admission. Diagnostic abdominal US and contrast-enhanced CT were performed, which revealed liver injury associated with intraperitoneal hemorrhage caused by sternal compression, therefore, emergency direct surgical ligation was undertaken. Despite a transient worsening of the respiratory condition immediately after the surgery, the patient showed uneventful clinical progress after transfer from the ICU, and he was discharged on foot on postoperative day 28. Hepatic injury caused by cardiopulmonary resuscitation using an automated sternal compression device is extremely rare. The present case underscores the need in medical practice to bear in mind the possibility of serious hepatic injury following cardiopulmonary resuscitation in patients whose hemodynamic state remains unstable despite adequate treatment of the primary disease after resuscitation.
AB - A 69-year-old man presented to a neighborhood hospital complaining of malaise, and while being examined, developed cardiopulmonary arrest. Cardiopulmonary resuscitation was then carried out using an automated sternal compression device. Thereafter, he was rushed to our hospital, where emergency coronary arteriography was performed after a clinical diagnosis of acute myocardial infarction was made. Coronary revascularization was accomplished by thrombus aspiration, stent placement, and anticoagulant therapy. While the clinical course was uneventful in the initial period after admission to the intensive care unit (ICU), the patient developed circulatory shock of sudden onset at 6 hours after ICU admission. Diagnostic abdominal US and contrast-enhanced CT were performed, which revealed liver injury associated with intraperitoneal hemorrhage caused by sternal compression, therefore, emergency direct surgical ligation was undertaken. Despite a transient worsening of the respiratory condition immediately after the surgery, the patient showed uneventful clinical progress after transfer from the ICU, and he was discharged on foot on postoperative day 28. Hepatic injury caused by cardiopulmonary resuscitation using an automated sternal compression device is extremely rare. The present case underscores the need in medical practice to bear in mind the possibility of serious hepatic injury following cardiopulmonary resuscitation in patients whose hemodynamic state remains unstable despite adequate treatment of the primary disease after resuscitation.
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U2 - 10.5833/jjgs.2016.0107
DO - 10.5833/jjgs.2016.0107
M3 - Article
AN - SCOPUS:85017467529
SN - 0386-9768
VL - 50
SP - 296
EP - 302
JO - Japanese Journal of Gastroenterological Surgery
JF - Japanese Journal of Gastroenterological Surgery
IS - 4
ER -