Grade 4 Liver Laceration after Cardiopulmonary Resuscitation: A Case Report

Cardiopulmonary resuscitation (CPR) is a life-saving medical procedure used in the setting of cessation of cardiac and respiratory function of a patient to maintain vital functions. CPR was developed in the 1950s as mouth to mouth resuscitation. Defibrillation, chest compression and ventilation were added to CPR in 1960. Chest compressions are thought to be the most important aspect of CPR and adequate performance of chest compression is required for successful resuscitation as emphasized in recent guidelines. However, chest compressions may be a source of injury to ribs, sternum, spleen, stomach, or liver. We present a case of a 30-year-old female with end-stage renal disease, hypertension, polysubstance abuse, and GERD who underwent CPR resulting in a grade 4 liver laceration. The new guidelines of Advanced Cardiac Life Support emphasize the need of regular forceful chest compressions during CPR which, although required for proper resuscitation of the patient may result in significant injuries to the viscera as seen in this patient. The aim of this case report is to highlight the possible complications of CPR and its long-term consequences.