title: Major hemorrhage from hepatic laceration after cardiopulmonary resuscitation.
abstract: Visceral injury from cardiac arrest resuscitation is a rare but potentially life-threatening complication. We describe and review 2 cases of hepatic laceration complicated by major abdominal hemorrhage manifested as delayed shock following cardiopulmonary resuscitation after cardiac arrest. Two patients enrolled in our institutional post cardiac arrest resuscitation clinical pathway had evidence of major liver laceration presenting as delayed shock due to massive hemoperitoneum. Case analysis revealed coagulopathy due to systemic anticoagulation as a risk factor for major hemorrhage. Both cases were successfully managed via hepatic artery embolization. Visceral abdominal injuries are an uncommon but important complication of cardiopulmonary resuscitation.Coagulopathy, including therapeutic systemic anticoagulation, is a risk factor for clinically significant hemorrhage.
authors: Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN. Electronic address: gzahn@iuhealth.org.
authors: GregoryS
authors: G
authors: Zahn
authors: Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC.
authors: MargaretG
authors: M
authors: Hauck
authors: Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC.
authors: David A
authors: DA
authors: Pearson
authors: Department of Surgery, Carolinas Medical Center, Charlotte, NC.
authors: John M
authors: JM
authors: Green
authors: Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC; Division of Critical Care Medicine, Department of Internal Medicine, Carolinas Medical Center, Charlotte, NC.
authors: Alan C
authors: AC
authors: Heffner
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008099:Liver / Q000293:injuries*; D012771:Shock, Hemorrhagic / Q000175:diagnosis / Q000209:etiology*