TITLE:
Gastric laceration after cardiopulmonary resuscitation: A case report
AUTHORS:
Rita Simone Lopes Moreira, Solange Guizilini, Natasha Marcondes, Ramiro Colleoni, Isadora S. Rocco, Iran Gonçalves, Ana Christina Velloso Caluza, Vinicius Santos Batista, Antonio Carlos de Camargo Carvalho
KEYWORDS:
Cardiac Arrest; Ventilation; Emergency Care; Complications; Gastric Injury; Cardiopulmonary Resuscitation
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.3 No.1,
January
21,
2014
ABSTRACT: The cardiopulmonary
resuscitation (CPR) persists as the best practice to maintain cerebral and coronary perfusion after cardiac arrest. Due to the chest compressions and ventilation maneuvers during resuscitation, there
are common complications reported. Abdominal organs injuries occur in
approximately 30% of patients, although studies show that they are under diagnosticated.
The aim of this article is to report a case of massive digestive hemorrhage by
gastric laceration after cardiopulmonary resuscitation, due to the event severity and rare clinic diagnostic. A
75-year-old Caucasian man suffered a sudden malaise and cardiac arrest and transferred
to an Emergency Unit (EU). The set of measures recommended by Advanced Cardiac
Life Support (ACLS) was performed. Despite no resistance to the passage
of nasogastric survey and spontaneous healing of fresh blood exteriorization,
an endoscopy showed ulcers in gastric notch with clots adhered and active
blood. There was no track record of liver or gastrointestinal diseases on this
patient, identifying a gastric laceration after cardiopulmonary resuscitation.
The mechanism by which the gastric laceration after CPR occurred is
uncertain. Nevertheless, some precipitating factors are considered such as
positioning of the patient during CPR, ideal point of compressions and ventilation pressure. In conclusion, this event is rare
with a hard diagnostic however that could be avoided and minimized with preventive
measures.