Journal of the Japanese Association for the Surgery of Trauma
Online ISSN : 2188-0190
Print ISSN : 1340-6264
ISSN-L : 1340-6264

This article has now been updated. Please use the final version.

LAPAROTOMY FOR POST-CHEST COMPRESSION LIVER INJURY UNDER THE USE OF VENO-ARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION
Yusuke TANINOHiroshi HOMMAYuta ISHIGAMIKeiichiro SHIMOYAMAJumpei TAKASHIMAKenta AIDAMasaru HIRAYAMAShoji SUZUKI
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JOURNAL FREE ACCESS Advance online publication

Article ID: 37.3_02

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Abstract

  Liver injuries associated with chest compressions are difficult to treat when veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is used. We report two cases of delayed liver injury after extracorporeal cardiopulmonary resuscitation cured by laparotomy. One case of liver injury appeared after percutaneous coronary intervention, resulting in abdominal compartment syndrome and emergency laparotomy. The other case of hemorrhagic ascites increased after V-A ECMO was started, resulting in emergency laparotomy. Both patients survived. V-A ECMO required the use of anticoagulants and intra-abdominal hemorrhage caused decreased venous return and increased intra-abdominal hypertension. Our case studies suggest that emergency laparotomy can safely be performed to stop bleeding with liver injury under V-A ECMO.

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