Five cases of acute hemorrhage of the upper-gastro-intestinal tract due to gastric and esophageal lacerations complicating closed-chest cardiac massage were observed by an autopsy service of a general teaching hospital over a 16-month period. During the same time, 348 autopsies were performed, including 50 patients who had received closed-chest cardiac massage. Fractured ribs were found in 20 patients (40%) while gastric and esophageal lacerations were the second most frequently encountered significant complication (10%). Prevention, early recognition, and prompt decompression of acute gastric distention during cardiopulmonary resuscitation is emphasized as a method of preventing gastroesophageal lacerations during external cardiac massage.
Lundberg GD, Mattei IR, Davis CJ, Nelson DE. Hemorrhage From Gastroesophageal Lacerations Following Closed-Chest Cardiac Massage. JAMA. 1967;202(3):195-198. doi:10.1001/jama.1967.03130160069012