Massive pulmonary embolism with liver injury associated with chest compressions during cardiac resuscitation.

Abstract

A 34-year-old man was admitted to our hospital because of sudden respiratory failure caused by massive pulmonary embolism. After arrival in the hospital, the patient experienced cardiopulmonary arrest, and we promptly initiated percutaneous cardiopulmonary support, in addition to sternal compressions for cardiopulmonary resuscitation. Computed tomography revealed massive pulmonary embolisms and intraperitoneal bleeding due to liver injury. After interventional hemostasis of the hepatic arteries, we performed emergent pulmonary embolectomy and hemostasis of the liver with gauze packing. Absence of further intraperitoneal bleeding was confirmed 2 days later on a second look. The patient was discharged 2 month later without neurologic sequelae.