Zweizeitige Leberruptur als Komplikation der äußeren Herzmassage

Abstract

A delayed rupture of the liver after resuscitation is reported. In the case of a 27-year-old woman, pulmonary embolism was followed by asystolia, which was remedied by external cardiac massage. This procedure caused ruptures of the liver, which first led to the formation of a subcapsular hematoma and 5 1/2 hours later, due to a secondary rupture of the capsule, led to internal bleeding and death. Degenerative changes of the parenchyma cells in the vicinity of the rupture were recognized, as well as fibrin separations on the detached Glisson's capsule, as signs of a survival period of several hours. Histological investigation of the lungs revealed a hepatocellular embolism and--in the absence of rib or sternum fractures--fat and bone-marrow embolisms. The morphological findings are discussed with reference to pertinent reports in the literature.

Cardiopulmonary Resuscitation Complicated by Traumatic Hepatic Laceration: A Case Report and Review of Literature

“…However, there are instances of injury to the right lobe as well [6,17]. Pollak et al in an autopsy series showed that the most common CPR-related liver lacerations occur on the medial line [18]. Several authors have questioned whether the method of chest compressions, in terms of who (or what, in the case of an automatic device) performs them and the technique used, have any bearing on the incidence of liver (and other intra-abdominal) injury.…”

A 15-year review of lightning deaths in Germany—with a focus on pathognomonic findings

“…Another common mistake that can lead to an incorrect diagnosis is to not undress the deceased during an external postmortem examination [6][7][8]. Another source of error is a lack of diligence of the doctor performing the external postmortem examination, with essential findings being overlooked [4,6].…”

“…Another source of error is a lack of diligence of the doctor performing the external postmortem examination, with essential findings being overlooked [4,6]. Furthermore, the lack of knowledge about pathognomonic or characteristic findings may also lead to an incorrect diagnosis [5][6][7][8]13]. Even after a correctly performed external postmortem examination obtaining the diagnosis correctly can be difficult in cases with discrete or no findings, even after lightning strike [9,14].…”

“…Fatal accidents caused by lightning are divided into observed and unobserved events. The rarity of the occurrence of fatal lightning accidents, the possibility of events with discrete characteristic findings, lack of knowledge, and insufficient care on the part of the doctor performing the external postmortem examination favor misjudging the correct cause of death [4][5][6][7][8][9][10].…”