Abstract
We reported a case of gastric rupture after a Heimlich maneuver and cardiopulmonary resuscitation, that could improved by conservative management. An 81-year-old male suffered airway obstruction while eating Japanese-motchi. His son at the scene performed the Heimlich maneuver but didn't succeed. Subsequently the patient became unconscious and cardiopulumonry arrest. Standard basic cardiac life support was also administered. After that, paramedics could remove the lodged foods using laryngoscope and forceps. The patient regained spontaneous breathing but was semiconscious, so he was transported to emergency department. On physical evaluation, the patient had abdominal distension with tenderness. Chest X-ray, computed tomography and gastro-intestinal fiberscopy had be shown evidence of a gastric rupture. Because of his hemodynamic stability, lack of peritoneal sign, and high surgical risk, non-operative management was successfully administered. To our knowledge, this is the first case reported of the survived conservative management of the gastric rupture following the Heimlich maneuver. Although, not the standard approach to traumatic gastric rupture, conservative management should be considered as an option in such selected patients. This case, as well as others reported in the literature, demonstrates that clinical acuity is necessary to recognize the rare but serious complications of the Heimlich maneuver and to maximize patient survival.
