Shock and dyspnea after cardiopulmonary resuscitation: a case of iatrogenic gastric rupture.
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.
Piardi
T
T
Department of Medical and Surgical Sciences, University of Brescia, Spedali Civili di Brescia.
D'Adda
F
F
Palmieri
F
F
Vettoretto
N
N
Lanzi
S
S
Pouchè
A
A
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*