Unexpected bleeding after cardiopulmonary resuscitation

Avulsion of the gallbladder is an uncommon complication after cardiopulmonary resuscitation. It has never been reported before. Cardiopulmonary resuscitation is frequently associated with complications such as rib and sternal fractures. Visceral structures are less affected. Abdominal organs might be injured, most frequently due to fractured ribs and/or the sternal bone. We report on a patient who suffered a circulatory arrest. After cardiopulmonary resuscitation, he developed haemorrhagic shock. Major abdominal bleeding was detected by CT imaging, principally in the upper right quadrant. Emergency laparotomy was performed. The bleeding was found to be caused by an avulsion of the gallbladder secondary to cardiopulmonary resuscitation. Haemodynamic instability after cardiopulmonary resuscitation is not always caused by cardiogenic shock. It is important to be aware of the possibility of traumatic abdominal laceration and bleeding. Early diagnostic measures and emergency surgery can be lifesaving.