Hepatic trauma during cardiac surgery

Two patients undergoing routine cardiac surgical procedures developed hypovolemic shock following cardiopulmonary bypass. They were found to have hemoperitoneum due to liver injuries. In the first case, intraabdominal hemorrhage was not diagnosed soon enough to save the patient. In the second case, immediate abdominal exploration led to prompt repair of the injury and resuscitation of the patient. We suggest that unexplained hypovolemic shock following cardiopulmonary bypass should be evaluated by immediate abdominal exploration to rule out hemoperitoneum.