Tang MM, Fang DF, Liu B. Upper gastrointestinal bleeding from a Mallory-Weiss tear associated with transesophageal echocardiography during successful cardiopulmonary resuscitation: A case report. World J Clin Cases 2022; 10(9): 2954-2960 [PMID: 35434104 DOI: 10.12998/wjcc.v10.i9.2954]
Corresponding Author of This Article
Bin Liu, MD, PhD, Chief Doctor, Department of Anesthesiology, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Chengdu 610041, Sichuan Province, China. liubinhxyy@163.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 26, 2022; 10(9): 2954-2960 Published online Mar 26, 2022. doi: 10.12998/wjcc.v10.i9.2954
Upper gastrointestinal bleeding from a Mallory-Weiss tear associated with transesophageal echocardiography during successful cardiopulmonary resuscitation: A case report
Miao-Miao Tang, Deng-Feng Fang, Bin Liu
Miao-Miao Tang, Deng-Feng Fang, Bin Liu, Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Tang MM was the anesthesia fellow who was in charge of the patient’s transesophageal echocardiography, reviewed the literature and contributed to manuscript drafting; Fang DF was the patient’s attending anesthesiologist, led the patient's rescue process and contributed to manuscript drafting; Liu B was responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bin Liu, MD, PhD, Chief Doctor, Department of Anesthesiology, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Chengdu 610041, Sichuan Province, China. liubinhxyy@163.com
Received: November 9, 2021 Peer-review started: November 9, 2021 First decision: December 27, 2021 Revised: January 5, 2022 Accepted: February 10, 2022 Article in press: February 10, 2022 Published online: March 26, 2022
Abstract
BACKGROUND
In recent years, it has been recognized that transesophageal echocardiography (TEE) is of great value in resuscitation of cardiac arrest. However, its safety has rarely been reported.
CASE SUMMARY
We present a 59-year-old male patient scheduled to undergo cardiac surgery for rheumatic heart disease. Upper gastrointestinal bleeding from a Mallory-Weiss tear appeared following cardiopulmonary resuscitation, TEE, and percutaneous cardiopulmonary bypass resuscitation when he suffered from aesthesia-related cardiac arrest. Gastrointestinal injury was diagnosed promptly and treated effectively. However, the exact etiology of gastrointestinal injury was unclear; the interaction of closed-chest cardiac massage and the application of TEE may be involved as a most possible mechanism of injury.
CONCLUSION
Serious complications should be considered when TEE is used in patients with special pathophysiological conditions.
Core Tip: In recent years, transesophageal echocardiography (TEE) has been recognized as a valuable imaging tool to provide diagnostic and prognostic information for both cardiopulmonary resuscitation (CPR) cases and non-CPR cases. Although it is generally considered safe, some serious complications, including esophageal perforation and mucosal damage, have been observed in non-CPR cases. To our knowledge, there is no literature on the safety of TEE during CPR. We here report the first case of upper gastrointestinal bleeding from a Mallory-Weiss tear associated with TEE during successful CPR and percutaneous cardiopulmonary bypass resuscitation.
