Extracardiac Tamponade and Hemoperitoneum After Cardiopulmonary Resuscitation: Multimodal Diagnosis Using Point-of-Care Ultrasonography and Transesophageal Echocardiography.

Cardiopulmonary resuscitation (CPR) is associated with iatrogenic complications, including thoracic and intra-abdominal injuries. We present two cases of post-resuscitation hemodynamic instability caused by intra-abdominal hemorrhage. In the first case, hemoperitoneum from splenic injury was rapidly identified using point-of-care ultrasonography (POCUS), prompting emergent surgical intervention. In the second case, a hepatic hematoma resulted in extrinsic compression of the right atrium (RA) and right ventricle (RV), producing extracardiac tamponade physiology confirmed with transesophageal echocardiography (TEE). These cases highlight the importance of early multimodal imaging in patients with unexplained shock following return of spontaneous circulation (ROSC). These complications are relevant to anesthesiologists and intensivists, who are frequently responsible for the perioperative and critical care management of patients following cardiac arrest.