Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
Online ISSN : 1882-5133
Print ISSN : 1345-2843
ISSN-L : 1345-2843
Case Reports
A case of liver injury caused by cardiopulmonary resuscitation of a woman immediately post-partum
Hiroyoshi MATSUKAWAShigehiro SHIOZAKINorihisa TAKAKURAYasuhiro FUJIWARASatoshi OHNOMotoki NINOMIYA
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2010 Volume 71 Issue 9 Pages 2402-2405

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Abstract

We report a case of liver injury caused by cardiopulmonary resuscitation (CPR). A 31-year-old pregnant woman developed convulsions just after delivery and went into respiratory arrest and shock. She was emergently transported under cardiopulmonary resuscitation by bag-mask respiration and closed-chest cardiac massage. Her respiration recovered, and her shock improved with CPR and intensive care. She was diagnosed as having an amniotic fluid embolism, and developed a serious coagulopathy related to obstetrical DIC. Subsequently, abdominal distention and hypovolemic shock were noted and gradually progressed. Abdominal CT showed massive bleeding from the left lateral segment of the liver. Emergency laparotomy revealed massive intraperitoneal hemorrhage from hepatic capsule rupture caused by widespread subcapsular hematoma originating in a parenchymal laceration located at the lateral segment. She recovered after hemostatic surgery and was discharged on the twelfth postoperative day. The liver of a pregnant woman is soft and vulnerable to trauma ; furthermore, obstetrical DIC accelerates hemorrhage. In addition, CPR, which is lifesaving, has nevertheless the unintended potential to result in liver injury in patients with these pre-conditions.

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© 2010 Japan Surgical Association
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