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Arkuszewski P. Location of liver lacerations resulting from deceleration injuries and a proposal for their classification. POLISH JOURNAL OF SURGERY 2021; 93:30-39. [DOI: 10.5604/01.3001.0015.4548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
<b>Aim:</b> The aim of the study was to verify during forensic autopsies the occurrence of liver lacerations resulting from deceleration traumas in the locations reported in professional literature, and also to check whether they are located near the left coronary ligament and its extension, i.e. the left triangular liver ligament. </br></br> <b> Methods:</b> The liver injuries were assessed on the base of cases of forensic autopsies, performed at the Department of Forensic Medicine of the Medical University of Lodz from 1<sup>st</sup> September 2011 to 15<sup>th</sup> April 2014. In order to analyze the collected data, descriptive methods and statistical inference methods were used. </br></br> <b>Results:</b> Three types of liver rupture turned out to be characteristic and statistically significant: 1 – on the diaphragmatic surface of the right lobe between its two sectors; 2 – within the left lobe to the right (in segment IV) or to the left (in segment III) of the falciform ligament; 3 – located near the left coronary ligament (in segment II). </br></br><b> Conclusion:</b> Typical location of liver lacerations after deceleration trauma, i.e. the right triangular ligament and falciform ligament, are confirmed in the analysed autopsy material. The place not previously described in the literature, which should be regarded as a characteristic location of a liver rupture after deceleration trauma is the diaphragmatic surface of segment II of the left lobe.
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Affiliation(s)
- Piotr Arkuszewski
- Department of Experimental Surgery, Medical University of Lodz, Poland
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Chen W, Qi J, Shang Y, Ren L, Guo Y. Amniotic fluid embolism and spontaneous hepatic rupture during uncomplicated pregnancy: a case report and literature review. J Matern Fetal Neonatal Med 2018; 33:1759-1766. [PMID: 30394159 DOI: 10.1080/14767058.2018.1526915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Amniotic fluid embolism (AFE) and spontaneous hepatic rupture both are extremely rare complications of pregnancy that can be fatal to mother and/or child. AFE is characterized by a sudden collapse of the cardiovascular system, a change in mental status, and disseminated intravascular coagulation (DIC), occurring immediately during labor, delivery, or postpartum, caused by the inflow of amniotic components into the maternal circulation. Spontaneous hepatic rupture during pregnancy which is most often occurs alongside hypertensive disorders, eclampsia, or HELLP syndrome. We report on the case of a 28-year-old woman (G3P2) who is suffering from AFE and spontaneous hepatic rupture, without history of hypertensive disorders, preeclampsia/eclampsia, or HELLP syndrome, and she died suddenly after delivering of a severe asphyxial neonate within 1 h with postpartum of hepatic rupture and massive hemorrhage. The lack of typical clinical signs and symptoms resulted to the difficulty of early diagnosis. If AFE and hepatic rupture is highly suspected in a pregnant patient, a collaborative multidisciplinary approach is mandatory. Pregnancy women is simultaneously complicated in amniotic fluid embolism and spontaneous hepatic rupture, similar cases are infrequent in the literature, which is reviewed in this report, explore the pathophysiological changes, we hope that can be helpful for the prevention, diagnosis and treatment of similar cases.
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Affiliation(s)
- Wei Chen
- Department of Forensic Science, School of Basic Medical Sciences, Central South University, Changsha, China
| | - Jialin Qi
- Department of Pathology, School of Basic Medical Sciences, Central South University, Changsha, China
| | - Yanjie Shang
- Department of Forensic Science, School of Basic Medical Sciences, Central South University, Changsha, China
| | - Lipin Ren
- Department of Forensic Science, School of Basic Medical Sciences, Central South University, Changsha, China
| | - Yadong Guo
- Department of Forensic Science, School of Basic Medical Sciences, Central South University, Changsha, China
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Sertic F, Bosco P, Ferrara A, Heck P, Abu-Omar Y. ICD lead extraction: Not a benign procedure. External chest compression: Not a benign manoeuvre. JRSM Cardiovasc Dis 2017; 6:2048004017731040. [PMID: 28932393 PMCID: PMC5600297 DOI: 10.1177/2048004017731040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 08/06/2017] [Accepted: 08/11/2017] [Indexed: 11/16/2022] Open
Abstract
This is the case of a 45-year-old man who was electively admitted to our hospital for revision and extraction of his faulty implantable cardioverter–defibrillator lead and box. The procedure was complicated by cardiac tamponade requiring pericardiocentisis (unsuccessful) and cardiopulmonary resuscitation. The patient was then rushed to theatre for emergency sternotomy and institution of cardiopulmonary bypass. A tear in the superior vena cava was identified and repaired. Unfortunately, the patient suffered of a liver laceration, due to chest compression, which required emergency laparotomy. The aim of this report is to highlight the combination and management of two rare life-threatening complications that occurred in a single case.
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Nashiki H, Miyate Y, Terui Y, Otani M. Focused assessment with sonography for trauma (FAST) identifies liver injury following cardiopulmonary resuscitation. BMJ Case Rep 2017; 2017:bcr-2017-221421. [PMID: 28724601 PMCID: PMC5535084 DOI: 10.1136/bcr-2017-221421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Liver trauma is a recognised rare complication of cardiopulmonary resuscitation (CPR) and may be difficult to detect. We report a case of intraperitoneal haemorrhage due to liver injury following CPR in a 50-year-old man admitted to the intensive care unit. The haemorrhage was diagnosed with focused assessment with sonography for trauma (FAST). FAST can rapidly and easily diagnose liver injury. FAST is recommended for excluding haemoperitoneum in patients who are haemodynamically unstable after resuscitation.
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Affiliation(s)
- Hiroshi Nashiki
- Department of Critical Care Medicine, Iwate Prefectural Central Hospital, Morioka, Japan
| | - Yoshiharu Miyate
- Department of Critical Care Medicine, Iwate Prefectural Central Hospital, Morioka, Japan
| | - Yousuke Terui
- Department of Cardiology, Iwate Prefectural Central Hospital, Morioka, Japan
| | - Masayuki Otani
- Department of Cardiology, Iwate Prefectural Central Hospital, Morioka, Japan
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Beydilli H, Balci Y, Erbas M, Acar E, Isik S, Savran B. Liver laceration related to cardiopulmonary resuscitation. Turk J Emerg Med 2016; 16:77-79. [PMID: 27896328 PMCID: PMC5121265 DOI: 10.1016/j.tjem.2015.01.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 12/07/2014] [Accepted: 01/05/2015] [Indexed: 10/26/2022] Open
Abstract
Cardiopulmonary resuscitation (CPR) is recognized as a medical procedure performed to maintain vital functions of a person whose cardiac and respiratory functions have stopped. Chest compression is the most essential component of CPR and it is performed on the lower half of the sternum. During CPR, many complications may occur because of chest compressions, especially chest injuries including sternum and rib fractures. Rarely tracheal injury, rupture of the stomach, or liver or spleen injury may also occur as complications. In this study, we present two cases of liver injury caused by resuscitation. With this article, we want to emphasize the importance of making correct chest compressions.
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Affiliation(s)
- Halil Beydilli
- Department of Emergency Medicine, Faculty of Medicine, Mugla Sitki Kocman University, 48000 Mugla, Turkey
| | - Yasemin Balci
- Department of Forensic Medicine, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Melike Erbas
- Ministry of Justice, The Forensic Branch Manager of Forensic Medicine Institute of Mugla, Mugla, Turkey
| | - Ethem Acar
- Department of Emergency Medicine, Faculty of Medicine, Mugla Sitki Kocman University, 48000 Mugla, Turkey
| | - Sahin Isik
- Department of Forensic Medicine, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Bulent Savran
- Ministry of Justice, The Forensic Branch Manager of Forensic Medicine Institute of Mugla, Mugla, Turkey
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Wi J, Shin D. Liver Laceration with Hemoperitoneum after Cardiopulmonary Resuscitation. Korean J Crit Care Med 2014. [DOI: 10.4266/kjccm.2014.29.2.141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Jin Wi
- Division of Cardiology, Department of Internal Medicine, Yonsei University Health System, Seoul, Korea
| | - Dongho Shin
- Division of Cardiology, Department of Internal Medicine, Yonsei University Health System, Seoul, Korea
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Kapłon-Cieślicka A, Kosior DA, Grabowski M, Rdzanek A, Huczek Z, Opolski G. Coronary artery dissection, traumatic liver and spleen injury after cardiopulmonary resuscitation - a case report and review of the literature. Arch Med Sci 2013; 9:1158-61. [PMID: 24482665 PMCID: PMC3902713 DOI: 10.5114/aoms.2013.39235] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Revised: 07/30/2012] [Accepted: 08/07/2012] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - Dariusz A. Kosior
- Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
- Department of Noninvasive Cardiology and Hypertension, Central Clinical Hospital, the Ministry of the Interior, Warsaw, Poland
| | - Marcin Grabowski
- 1 Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Adam Rdzanek
- 1 Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Zenon Huczek
- 1 Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Grzegorz Opolski
- 1 Chair and Department of Cardiology, Medical University of Warsaw, Poland
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[Hemorrhagic shock after cardiopulmonary resuscitation, bedside ultrasonography interest]. ACTA ACUST UNITED AC 2012; 32:67-8. [PMID: 23245485 DOI: 10.1016/j.annfar.2012.10.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 10/22/2012] [Indexed: 11/21/2022]
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de Weerd Y, Kraaier K, Logtenberg M, Huisman A, von Birgelen C. Successful bystander cardiopulmonary resuscitation complicated by liver rupture. Neth Heart J 2011; 17:33-4. [PMID: 19148337 DOI: 10.1007/bf03086213] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Y de Weerd
- Department of Cardiology, Medical Spectrum Twente, Enschede, the Netherlands
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Meron G, Kurkciyan I, Sterz F, Susani M, Domanovits H, Tobler K, Bohdjalian A, Laggner AN. Cardiopulmonary resuscitation-associated major liver injury. Resuscitation 2007; 75:445-53. [PMID: 17640792 DOI: 10.1016/j.resuscitation.2007.05.023] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2007] [Revised: 05/22/2007] [Accepted: 05/23/2007] [Indexed: 11/21/2022]
Abstract
AIM To evaluate the frequency, presentation, treatment and outcome of cardiopulmonary resuscitation-associated major liver injury in patients after non-traumatic in- or out-of-hospital cardiac arrest. MATERIALS AND METHODS Retrospective analysis of a cardiac arrest registry in a tertiary care hospital emergency department. We reviewed patients charts, laboratory data, diagnostic imaging studies and autoptic findings. RESULTS Within 14.5 years, major liver injury (rupture/laceration, haemorrhage/haematoma) was found in 15 of 2558 cardiac arrest victims (0.6%). Eleven were male (73%), median age was 58 (IQR 53-67). In seven, resuscitation was started out-of-hospital. In 9 of the 15 patients, liver injury was correctly diagnosed intra vitam. In 5, haematocrit level was low on admission, in 8 haematocrit dropped significantly during observation; haemostasis was compromised in 13 patients, 4 of them receiving thrombolytic therapy. Bedside abdominal sonography showed free intra-peritoneal fluid in 8 of 9 cases examined. In 11 patients, we found liver rupture/laceration, in 4 liver haemorrhage/haematoma. The site of injury was the left liver lobe in 11, six underwent emergent surgery. Two of 15 patients survived to 6 months in good neurological condition, 1 after emergency surgery. No patient died from bleeding due to liver injury. CONCLUSION Our single centre observation confirms that resuscitation-associated major liver injury is infrequent and shows that most patients had compromised haemostasis. Low or dropping haematocrit should trigger suspicion. Bedside sonography reveals intra-peritoneal fluid or liver injury. A conservative therapeutic approach or emergency surgery may be warranted. Major liver injury alone scarcely appears to influence overall outcome.
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Affiliation(s)
- Giora Meron
- Department of Emergency Medicine, General Hospital of Vienna, Medical University of Vienna, Austria
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Moreno Millán E. Complicaciones de la resucitación cardiopulmonar en el paro cardiorrespiratorio por tromboembolismo pulmonar masivo tratado con fibrinolíticos. Med Intensiva 2001. [DOI: 10.1016/s0210-5691(01)79712-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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12
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Riera sagrera M, Soriano zaragoza G, Amengual alemany G, Morón canis J. Hemoperitoneo como complicación de la resucitación cardiopulmonar básica. Med Intensiva 2001. [DOI: 10.1016/s0210-5691(01)79655-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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