Major Scope

  •  Colon and Rectal Surgery
  •  General Surgery
  •  Gynecologic Oncology
  •  Plastic Surgery
  •  Neurological Surgery
  •  Orthopaedic Surgery
  •  Orthopaedic Surgery of the Spine
  •  Neonatal Surgery
  •  Prenatal Surgery
  •  Trauma Surgery
  •  Surgical Intensivists, Specializing In Critical Care Patients
  •  Thoracic Surgery
  •  Congenital Cardiac Surgery
  •  Thoracic Surgery-Integrated
  •  Vascular Surgery

Abstract

Citation: Clin Surg. 2016;1(1):1113.Case Report | Open Access

Iatrogenic Splenic Laceration from Cardiopulmonary Resuscitation - A Rare Complication

Sim KS, Lee SY, Tay HT and Chan CY

Department of General Surgery, Singapore General Hospital, Singapore
Department of Hepatopancreatobiliary & Transplant Surgery and General Surgery, Singapore General Hospital, Singapore

*Correspondance to: Ser Yee Lee 

 PDF  Full Text DOI: 10.25107/2474-1647.1113

Abstract

Background: Chest compressions during cardiopulmonary resuscitation have been shown to cause unintended injury to its receiver. Intra-abdominal complications remain a rare but dangerous occurrence. We present a rare case of an iatrogenic splenic laceration and its management in a patient who had received cardiopulmonary resuscitation prior, along with a brief review of the literature.Case
Presentation: A 69-year-old gentleman with ischaemic heart disease underwent an elective cardiac catheterization and coronary angioplasty. The procedure was complicated by a rupture of the left circumflex artery, pericardial tamponade and cardiogenic collapse. He received cardiopulmonary resuscitation and required extracorporeal membrane oxygenation, intra-arterial balloon pump insertion and a sternotomy for haemostasis. On post-operative day one, he presented with a tense abdomen with haemodynamic instability. Computed tomography of his abdomen revealed a significant amount of haemoperitoneum with no definite source identified. Emergency exploratory laparotomy was performed with intra-abdominal four quadrant packing. The bleeding source was identified to be a splenic laceration. Haemostasis was secured with capsular stitching and the use of topical haemostatic agents without requiring a splenectomy. There was no occurrence of re-bleed post operatively. A brief review of the literature revealed 12 documented cases of splenic injuries post cardiopulmonary resuscitation. Of these, 7 patients were successfully managed with a splenectomy and 1 with splenic artery embolization.Conclusion: The importance of early detection of rare but life-threatening extra-thoracic complications of cardiopulmonary resuscitation is thus highlighted, and should be routinely considered in patients who have received chest compressions so as to allow for early intervention.

Keywords

Cite the article

Sim KS, Lee SY, Tay HT, Chan CY. Iatrogenic Splenic Laceration from Cardiopulmonary Resuscitation � A Rare Complication. Clin Surg. 2016; 1: 1113.

Journal Basic Info

  • Impact Factor: 2.395**
  • H-Index: 8
  • ISSN: 2474-1647
  • DOI: 10.25107/2474-1647
  • NLM ID: 101702548

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