A Case of Gastric Rupture Resulting from Cardiopulmonary Resuscitation

Abstract

A 73-year-old woman was scheduled to receive preoperative treatment for locally advanced pancreatic head cancer. She suddenly developed hematemesis and a bloody bowel discharge. Marked anemia and severe shock were observed at the time of admission. Contrast-enhanced abdominal computed tomography revealed leakage of the contrast agent from the gastroduodenal artery, and emergency embolization was performed. During hospitalization, the patient developed ventricular tachycardia, which improved following cardiopulmonary resuscitation. Abdominal radiography performed the following day revealed free air inferior to the right dome of the diaphragm. Contrast-enhanced abdominal CT confirmed a large quantity of free air in her abdominal cavity. Thus, she was diagnosed as having a gastric perforation, and an emergency laparotomy was performed on the same day. During laparotomy, a laceration measuring approximately 7cm was found along the lesser curvature of the upper body of the stomach. The patient was diagnosed as having a gastric rupture that occurred during the cardiopulmonary resuscitation. The ruptured area was sutured following drainage of the abdominal cavity. She was discharged on the 13th postoperative day. Since gastric ruptures are a rare complication of cardiopulmonary resuscitation, we report herein on this case with a review of the relevant literature.