Rupture of Stomach After Attempted Heimlich Maneuver

To the Editor.— I refer to the recent report by Roehm et al entitled "Abdominal Aortic Thrombosis in Association With an Attempted Heimlich Maneuver" (1983;249:1186). I recently performed a medical examiner autopsy on a patient with rupture of the stomach after an attempted Heimlich maneuver. Report of a Case.— A 39-year-old man was a rest home resident with cerebral palsy, organic brain syndrome, epilepsy, and diabetes mellitus. During a noon meal, he collapsed and ceased breathing. The Heimlich maneuver was attempted several times by a food service employee making a delivery to the rest home. No foreign body was obtained. A rest home employee then performed mouth-to-mouth resuscitation with restoration of spontaneous respirations. During transport to a hospital by emergency medical personnel, the patient vomited or coughed up a mass of food material 3.8 cm (1.5 in) in diameter. On arrival at the emergency room, the patient was cyanotic and