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Case Reports in Emergency Medicine
Volume 2015, Article ID 275497, 4 pages
Case Report

Food Particle Aspiration Associated with Hemorrhagic Shock: A Diagnostic Dilemma

1Department of Pulmonary and Critical Care Medicine, Cleveland Clinic Florida, Weston, FL, USA
2Department of Otolaryngology, Cleveland Clinic Florida, Weston, FL, USA

Received 8 January 2015; Revised 8 May 2015; Accepted 10 May 2015

Academic Editor: Ritesh Agarwal

Copyright © 2015 Basheer Tashtoush et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The hemodynamic compromise caused by a large aspirated food particle in the airway can become the focus of medical attention and a distraction from rare but fatal Heimlich maneuver related injuries after an incident of food aspiration. We herein present a case of an 84-year-old man who was brought to the emergency department after an episode of choking at a restaurant followed by several failed Heimlich maneuver attempts. Despite relieving the airway obstruction by extracting a large piece of steak from the airway, the patient remained hypotensive and required continued hemodynamic support. Repeated laboratory tests within 24 hrs of aspiration showed a significant decline in the hemoglobin level. A computed tomography (CT) scan of the abdomen and pelvis showed a lacerated liver with a large subcapsular hematoma draining into the pelvis. Conclusion. Hepatic rupture is a rare complication of Heimlich maneuver; this paper represents the second case report in the literature. It emphasizes the necessity of early identification and surveillance of fatal Heimlich maneuver complications in a high risk population.