Occult splenic rupture with cardiovascular collapse: a report of three cases in critically ill patients

Kandasamy, Subramani; Thomas, Antony; Reeve, Roy

doi:10.1007/s00134-002-1537-6

Cited by 5 publications

(4 citation statements)

References 18 publications

(20 reference statements)

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“…Common causes of delayed bleeding from splenic injury are pseudoaneurysms, pseudocysts, or disruption of the subcapsular hematoma 7 . To the best of our knowledge, delayed bleeding from splenic injury after CPR has rarely been reported 8,9 …”

Section: Discussionmentioning

confidence: 99%

“…7 To the best of our knowledge, delayed bleeding from splenic injury after CPR has rarely been reported. 8,9 Delayed bleeding is typically associated with coagulation abnormalities, specifically therapeutic anticoagulation, systemic thrombolytic therapy, antiplatelet therapy, thrombocytopenia, and coagulopathy. A case series identified coagulation abnormalities in 13 of the 15 patients with CPR-related liver injury.…”

Section: Discussionmentioning

confidence: 99%

“… 7 To the best of our knowledge, delayed bleeding from splenic injury after CPR has rarely been reported. 8 , 9 …”

Section: Discussionmentioning

confidence: 99%

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Delayed massive bleeding from minor splenic injury due to mechanical chest compression for cardiopulmonary resuscitation

Yamada¹,

Nakao²,

Fukuma³

et al. 2023

Acute Medicine & Surgery

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BackgroundSplenic injury due to chest compressions is a rare and fatal complication that occurs immediately after cardiopulmonary resuscitation.Case PresentationCardiopulmonary resuscitation was carried out using a mechanical chest compression device in a 74‐year‐old Japanese female patient who underwent cardiac arrest. Computed tomography postresuscitation revealed bilateral anterior rib fractures. Other traumatic findings were not observed. Coronary angiography revealed no new lesions; the cause of the arrest was hypokalemia. She received mechanical support with venoarterial extracorporeal membrane oxygenation and multiple antithrombotic agents. Her hemodynamic and coagulative condition became life‐threatening on day 4; abdominal ultrasound revealed massive bloody ascites. Only a minor splenic laceration was observed intraoperatively, despite massive bleeding. Furthermore, her condition stabilized after splenectomy and blood transfusion. Venoarterial extracorporeal membrane oxygenation was discontinued on day 5.ConclusionIn patients with postcardiac arrest, delayed bleeding due to minor visceral injury should be considered, particularly for coagulation abnormalities.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Delayed massive bleeding from minor splenic injury due to mechanical chest compression for cardiopulmonary resuscitation

Yamada¹,

Nakao²,

Fukuma³

et al. 2023

Acute Medicine & Surgery

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show abstract

“…In a CPR‐related splenic injury case series, chest compression leading to gastrosplenic ligament traction causing vascular injury was reported. 6 …”

Section: Discussionmentioning

confidence: 99%

Splenic injury caused by cardiopulmonary resuscitation in a full stomach with hematoma after hemorrhagic shock due to bleeding duodenal ulcer: A case report

Fujimori,

Koyama,

Ooki

et al. 2024

Acute Medicine & Surgery

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BackgroundCardiopulmonary resuscitation is essential for cardiopulmonary arrest, but complications from chest compressions warrant monitoring. Although rib and sternal fractures are common, abdominal injuries are rare, and splenic injuries are much rarer.Case PresentationA 74‐year‐old man was admitted to the emergency room with a hemorrhagic duodenal ulcer. During hospitalization, the patient went into cardiopulmonary arrest due to hemorrhagic shock. Spontaneous circulation returned after 7 min of cardiopulmonary resuscitation. He underwent transcatheter arterial embolization to stop the bleeding from the duodenal ulcer. The next day, a close examination of the patient's progressive anemia revealed splenic injury; transcatheter arterial embolization was performed to save his life.ConclusionIt is important to consider the complication of splenic injury in patients with cardiopulmonary arrest who have undergone appropriate cardiopulmonary resuscitation. A possible mechanism—especially in patients with a full stomach—is the squeezing of the spleen by the diaphragm, abdominal wall, and stomach.

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The forensic spleen: Morphological, radiological, and toxicological investigations

Palmière

Tettamanti²,

Scarpelli

et al. 2018

Forensic Science International

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Occult splenic rupture with cardiovascular collapse: a report of three cases in critically ill patients

Cited by 5 publications

References 18 publications

Delayed massive bleeding from minor splenic injury due to mechanical chest compression for cardiopulmonary resuscitation

Delayed massive bleeding from minor splenic injury due to mechanical chest compression for cardiopulmonary resuscitation

Splenic injury caused by cardiopulmonary resuscitation in a full stomach with hematoma after hemorrhagic shock due to bleeding duodenal ulcer: A case report

The forensic spleen: Morphological, radiological, and toxicological investigations

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