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Acute abdomen after cardiac arrest and implantation of a system for extracorporeal membrane oxygenation (ECMO)

    Author: Christian Loewe, Vienna, Austria
    Body Region: Cardiovascular

    1. Patient presentation
    2. CT Images
    3. CT Findings
    4. Diagnosis
    5. Further clinical course
    6. References

    1. Patient presentation

    • An 80-year-old man initially presented with severe mitral valve regurgitation and multivessel coronary artery disease.
    • Mitral valve reconstruction and coronary bypass graft surgery were performed.
    • Due to a prolonged postoperative phase complicated by acute respiratory distress syndrome (ARDS) and a third-degree atrioventricular bundle block, a system for extracorporeal membrane oxygenation (ECMO) was implanted.
    • ECMO support had to be left in place for two weeks, as two attempts at discontinuation failed. In addition, two hemorrhagic episodes caused by the ECMO cannulas occurred.
    • After 2 weeks the situation worsened further and the patient was referred for CT because of acute abdomen and raised lactate levels (Figures 1 and 2).
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