A 61-year-old female with a history of gastroesophageal reflux disease and hiatal hernia developed hemopericardium and tamponade one day after laparoscopic hiatal hernia repair and Toupet fundoplication. The patient underwent emergency pericardiocentesis and subsequent surgical pericardial window. During surgery, a tack that had been used to secure the mesh to the inferior aspect of the diaphragm was found to have penetrated the pericardium near the right ventricle. The patient recovered without further complications.
A 46-year-old man with gastroesophageal reflux disease underwent Nissen fundoplication with hiatal mesh reinforcement using absorbable tacks. Forty-eight hours after surgery, the patient developed hypotension and sweating. Cardiac magnetic resonance imaging showed a large pericardial effusion. Pericardiocentesis was performed with removal of 650 cc of bloody fluid. The pericardial drain could be removed two days later. The patient’s further course was uneventful.