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  • Ruptura želodca s pnevmoperitonejem - redkejša reanimacijska poškodba = Stomach rupture and pneumoperitoneum - a rare resuscitation injury
    Žmavc, Andrej ; Strouhal, P...
    Resuscitation maneuvers are aggressive and frequently cause various injuries to resuscitated patients. The reason is unproper resuscitation technique mostly but even with the state of the art ... tecnique injuries can not be avoided. In our case a stomach rupture with massive pneumoperitoneum is described. 48 years old female suddenly lost consciousness during swimming in a swimming pool. A rescuer present at that time immediately started BLS. A local physician and the rescuer had been performing cardiac massage and bag-valve-mask ventilation until our ALS team arrived 17 minutes later. The patient's abdomen was apparently distended at that time. An ECG monitor showedno electrical activity. The emergency physician intubated the patient immediately, started ACD cardiac massage and administered epinephrine in boluses of 1mg and 4mg subsequently. The patient remained unresponsive and theresuscitation was terminated in 35th minute of cardiac arrest. An autopsy revealed a ruptured aneurysm of ascending aorta with massive pericardiac tamponade as a cause of death. Injuries caused by resuscitation were: fractured ribs III. - V. on both sides of the sternum, multiple lacerations ofgastric mucosa at the minor curvature and rupture of gastric wall with greatamount of free air in peritoneal cavity. According to data in the literature, and in our case as well, the stomach rupture is very likely causedby too aggressive cardiac massage. A predisponding factor is hyperinflated stomach due to incorerct ventilation during BLS (improper position of the head, high inspiratory pressures). Once a dilated stomach is noticed, an immediate decompression by NG tube or transabdominal needle aspiration is recommended.
    Vir: Urgentna medicina = Emergency medicine : izbrana poglavja 3 = selected topics 3 : zbornik = proceedings : Četrti mednarodni simpozij o urgentni medicini = 4th International Symposium on Emergency Medicine : Portorož, Slovenija, 18.-21. junij 1997 (Str. 299-302)
    Vrsta gradiva - prispevek na konferenci
    Leto - 1997
    Jezik - slovenski
    COBISS.SI-ID - 6855385

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