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October 16, 1967

Hemorrhage From Gastroesophageal Lacerations Following Closed-Chest Cardiac Massage

Author Affiliations

From the Pathology Service, William Beaumont General Hospital, El Paso, Tex.

JAMA. 1967;202(3):195-198. doi:10.1001/jama.1967.03130160069012

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.