Major hemorrhage from hepatic laceration after cardiopulmonary resuscitation

Visceral injury from cardiac arrest resuscitation is a rare but potentially life-threatening complication. We describe and review 2 cases of hepatic laceration complicated by major abdominal hemorrhage manifested as delayed shock following cardiopulmonary resuscitation after cardiac arrest. Two patients enrolled in our institutional post cardiac arrest resuscitation clinical pathway had evidence of major liver laceration presenting as delayed shock due to massive hemoperitoneum. Case analysis revealed coagulopathy due to systemic anticoagulation as a risk factor for major hemorrhage. Both cases were successfully managed via hepatic artery embolization. Visceral abdominal injuries are an uncommon but important complication of cardiopulmonary resuscitation.Coagulopathy, including therapeutic systemic anticoagulation, is a risk factor for clinically significant hemorrhage.