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<p>Iatrogenic cardiac tamponade is a life-threatening complication in both cardiac and non-cardiac surgeries, with a notable risk during laparoscopic hiatal herniorrhaphy due to the diaphragm’s proximity to the pericardium. We report the case of a 71-year-old woman who presented with cardiovascular instability 48&#xa0;h after hernia repair. Imaging showed pneumomediastinum and a large pericardial effusion causing tamponade, which was initially managed with pericardiocentesis. Recurrent instability from a massive hemothorax required emergency thoracotomy, which revealed a pericardial perforation from a surgical tacker. The patient recovered following surgical repair and was discharged. This case emphasizes that cardiac tamponade should be a key differential diagnosis in post-hiatal herniorrhaphy patients with hemodynamic compromise. Careful surgical technique, particularly avoiding tackers on the diaphragm, and a high level of suspicion are essential for preventing and managing this severe complication.</p>

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Cardiac tamponade after laparoscopic hiatal herniorrhaphy: a rare but preventable iatrogenic complication

  • 期刊论文

  • 发表日期：

    2025年12月19日

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  • Mateo Londoño Barrientos,
  • Juan Pablo Sosa,
  • Laura Álvarez Herrera,
  • Carlos Alberto López Zapata,
  • Carlos Andres Delgado López

摘要

Iatrogenic cardiac tamponade is a life-threatening complication in both cardiac and non-cardiac surgeries, with a notable risk during laparoscopic hiatal herniorrhaphy due to the diaphragm’s proximity to the pericardium. We report the case of a 71-year-old woman who presented with cardiovascular instability 48 h after hernia repair. Imaging showed pneumomediastinum and a large pericardial effusion causing tamponade, which was initially managed with pericardiocentesis. Recurrent instability from a massive hemothorax required emergency thoracotomy, which revealed a pericardial perforation from a surgical tacker. The patient recovered following surgical repair and was discharged. This case emphasizes that cardiac tamponade should be a key differential diagnosis in post-hiatal herniorrhaphy patients with hemodynamic compromise. Careful surgical technique, particularly avoiding tackers on the diaphragm, and a high level of suspicion are essential for preventing and managing this severe complication.