title: Shock and dyspnea after cardiopulmonary resuscitation: a case of iatrogenic gastric rupture.
abstract: Rupture of the stomach is a rarely reported complication of cardiopulmonary resuscitation. The number of cases reported in the literature since 1970 does not exceed 30. We present a recent case of a young woman submitted to cardiopulmonary resuscitation in whom a gastric rupture gave rise to massive pneumoperitoneum with haemodynamic shock and respiratory failure. Major distension of the abdomen and an extensive subcutaneous emphysema were present. After re-establishing the haemodynamic conditions and a diagnostic spiral thoracic-abdomen CT scan, an emergency laparoptomy was performed. We found two linear defects of the lesser curvature of the stomach, which were treated by closure with a primary interrupted two-layer suture. The postoperative recovery was uneventful. Iatrogenic gastric rupture carries a high risk of mortality. A prompt diagnosis and emergency surgical repair are essential for patient survival.
authors.affiliation: Department of Medical and Surgical Sciences, University of Brescia, Spedali Civili di Brescia.
authors.forename: T
authors.initials: T
authors.lastname: Piardi
authors.forename: F
authors.initials: F
authors.lastname: D'Adda
authors.forename: F
authors.initials: F
authors.lastname: Palmieri
authors.forename: N
authors.initials: N
authors.lastname: Vettoretto
authors.forename: S
authors.initials: S
authors.lastname: Lanzi
authors.forename: A
authors.initials: A
authors.lastname: Pouchè
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects*; D004417:Dyspnea / Q000209:etiology*; D005260:Female; D006801:Humans; D012769:Shock / Q000209:etiology*; D013275:Stomach Rupture / Q000209:etiology*