Splenic injury caused by cardiopulmonary resuscitation in a full stomach with hematoma after hemorrhagic shock due to bleeding duodenal ulcer: A case report

Author:

Fujimori Daisuke1ORCID,Koyama Tomohide1,Ooki Satomi1,Ito Masaaki1,Yoshiike Yasutaka1,Nakamura Satoshi12,Yoshida Ryuhei1,Sakamoto So1ORCID,Ito Chikao1ORCID,Kasuya Miyuki1,Oe Kyoji1,Takahashi Isao1

Affiliation:

1. Department of Emergency and Critical Care Medicine Asahi General Hospital Chiba Japan

2. Department of Emergency and Critical Care Medicine Tochigi Prefectural Emergency and Critical Care Center, Imperial Foundation Saiseikai Utsunomiya Hospital Tochigi Japan

Abstract

AbstractBackgroundCardiopulmonary resuscitation is essential for cardiopulmonary arrest, but complications from chest compressions warrant monitoring. Although rib and sternal fractures are common, abdominal injuries are rare, and splenic injuries are much rarer.Case PresentationA 74‐year‐old man was admitted to the emergency room with a hemorrhagic duodenal ulcer. During hospitalization, the patient went into cardiopulmonary arrest due to hemorrhagic shock. Spontaneous circulation returned after 7 min of cardiopulmonary resuscitation. He underwent transcatheter arterial embolization to stop the bleeding from the duodenal ulcer. The next day, a close examination of the patient's progressive anemia revealed splenic injury; transcatheter arterial embolization was performed to save his life.ConclusionIt is important to consider the complication of splenic injury in patients with cardiopulmonary arrest who have undergone appropriate cardiopulmonary resuscitation. A possible mechanism—especially in patients with a full stomach—is the squeezing of the spleen by the diaphragm, abdominal wall, and stomach.

Publisher

Wiley

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