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עמוד בית
Fri, 21.06.24

CASE COMMUNICATIONS

IMAJ | volume 26

Journal 4, April 2024
pages: 251-253

Cardiac Tamponade: A Rare and Insidious Surgical Complication of Hiatal Hernia Repair

1 Department of General Surgery Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel 2 Department of Cardiothoracic Surgery, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel 3 Cardiovascular Institute, Division of Thoracic Surgery, Tzafon Medical Center, Lower Galilee, Israel 4 Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 5 Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel

Summary

Hiatal hernia is defined as a protrusion of abdominal contents through the hiatal foramen into the thoracic cavity. Etiology is presumed to be a congenital malformation, trauma, or iatrogenic like prior surgical dissection of the hiatus during surgery for esophageal or gastric etiology. Age, sex, hormonal changes, body habitus (i.e., kyphosis, scoliosis), and increased body weight are key risk factors. Most hiatal hernias are asymptomatic and discovered incidentally. Surgical repair of hiatal hernia is indicated in symptomatic patients with dysphagia, weight loss, respiratory symptoms such as aspirations, and recurrent pneumonia events [1]. Complications arising from laparoscopic repair of hiatal hernia are generally minor and do not typically necessitate surgical intervention. Major complications include pneumothorax, splenic laceration, esophageal rupture, and pericardial injury. Other complications include recurrence of hernia, vagal nerve injury, gastroesophageal reflux disease, and gastroparesis. The utilization of mesh in repair procedures introduces additional complications such as mesh migration and mesh infection. Previously reported recurrence rates following the repair of a hiatal hernia with mesh range from 10–30%. In this case communications, we presented a case involving the early recognition and treatment of postoperative cardiac tamponade.

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