Gastroesophageal lacerations. A fatal complication of closed chest cardiopulmonary resuscitation.

A case of fatal gastrointestinal hemorrhage from gastric mucosal lacerations related to the closed chest cardiac compression of cardiopulmonary resuscitation is reported. Previous autopsy series suggest that gastroesophageal lacerations may occur in 12 percent of cases not surviving cardiopulmonary resuscitation (CPR). In the presence of increasing out-of-hospital and lay-initiated resuscitation, recognition of this complication of closed chest compression seems to be of particular importance. Attention to the technique of chest compression and ventilation, including early intubation and gastric decompression, may help to minimize the incidence of gastric mucosal laceration occurring during CPR.