A 62-year-old woman with gastroesophageal reflux disease and a large hiatal hernia underwent Nissen fundoplication with mesh hiatoplasty using absorbable tacks. On postoperative day 5, the patient developed acute respiratory distress syndrome with hypotension and oliguria. A thoracic CT scan showed a bilateral pleural effusion and a large pericardial effusion that caused the collapse of the right atrium and ventricle. She was taken back to the operating room for urgent surgical pericardial drainage. After that, the postoperative course was uneventful.
A 40-year-old man underwent Collis-Nissen repair of gastroesophageal reflux disease. The night of the operation he became hypotensive and was believed to have cardiac tamponade. Bedside pericardiocentesis was performed with temporary improvement. On returning to the operating room, he coded and died on the operating table. The autopsy findings showed laceration of a coronary vessel.