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Hepatic cyst rupture: A hidden complication of chest compression

Yusuke Takeda, Hisayoshi Murai,Soichiro Usui, Kenji Sakata,Masaaki Kawashiri, MasayukiTakamura

Background: Chest compressions are absolutely essential to save the lives of those in cardiac arrest. However, chest compressions per se may induce certain complications. Here, we present a case of hepatic cyst rupture induced by chest compressions after ventricular fibrillation developed during percutaneous coronary intervention (PCI).

Case presentation: A 74-year-old male was admitted for PCI. Earlier computed tomography (CT) had incidentally revealed a large hepatic cyst. During PCI, ventricular fibrillation developed and the patient required cardiopulmonary resuscitation. Sinus rhythm recovery did not improve the hemodynamic stability. CT unexpectedly revealed an abdominal hematoma and extravasation of contrast medium from the ruptured hepatic cyst, causing hemorrhagic shock. We performed transcatheter arterial embolization, which stabilized the hemodynamics.

Conclusion: Chest compressions must be delivered carefully to patients at risk of hepatic cyst rupture. Careful consideration of adjacent organs around heart is required for prompt diagnosis and treatment to prevent serious shock.