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 70-year-old woman presented with a giant hiatal hernia with intrathoracic stomach. The patient underwent laparoscopic Nissen fundoplication with hiatal mesh reinforcement using absorbable tacks. On postoperative day 2, the patient developed hypotension, tachycardia, and irregular pulse.\nA CT scan revealed an extrapericardial hematoma in the hernia sac with mild left atrium compromise. Conservative treatment was decided and the patient discharged on postoperative day 15.