Abstract
A 43-year-old man suddenly became unconscious at a bus stop and developed cardiopulmonary arrest. A bystander performed cardiopulmonary resuscitation. Upon arrival at our hospital, an emergency coronary angiography was performed for a high index of suspicion for acute coronary syndrome, which revealed 90% stenosis of the left anterior descending branch of the left coronary artery. Additionally, percutaneous coronary dilatation was performed, and antithrombotic therapy using heparin was initiated. However, he showed a drop in his blood pressure and development of anemia within 18 hours. Computed tomography (CT) showed liver injury (grade IIIb) and massive intra-abdominal hemorrhage. Because subsequent abdominal angiography did not show any bleeding from the intrahepatic artery, conservative therapy was selected for management. Fortunately, his general condition improved, and he was discharged 20 days after admission. CT performed after discharge showed that his intrahepatic hematomas and intra-abdominal blood had localized and reduced. Hepatic injury and /or intra-abdominal bleeding should be considered as likely outcomes in a patient who has received cardiopulmonary resuscitation and antithrombotic therapy.
