Diffuse hepatic hemorrhage in a patient undergoing emergency conventional coronary artery bypass surgery following cardiopulmonary resuscitation

A 71-year-old male patient was admitted with a diagnosis of acute myocardial infarction, he underwent an urgent coronary angiography and stent implantation to a totally occluded circumflex coronary artery. During the percutaneous coronary intervention, cardiac arrest occurred and a short-lived and successful mechanical and medical cardiopulmonary resuscitation was applied. Once a satisfactory cardiac rhythm and arterial blood pressure were obtained, the patient underwent coronary artery bypass surgery on an emergency basis. During the operation, a high volume of intraabdominal hemorrhage secondary to hepatic injury was observed following additional exploratory laparotomy. We performed perihepatic packing for diffuse hepatic hemorrhage, since there was no particular focus of bleeding or rupture in the liver. In spite of accurate and sufficient fluid and blood product replacement, the patient died on account of hypovolemic shock. This report highlights the possibility of diffuse hepatic hemorrhage secondary to liver injury related to cardiopulmonary resuscitation. Correspondence to: Dr. Ahmet Yuksel, Department of Cardiovascular Surgery, Bursa State Hospital, Tophane Street, 16041, Bursa, Turkey, Tel: +90 505 8460753; Fax: +90 224 2132993; E-mail: [email protected]