Acute deterioration after emergency paraesophageal hernia repair

Cockbain, Andrew J.; Darmalingum, Ash; Mehta, Sam

doi:10.1016/j.surg.2015.08.018

Cited by 5 publications

(3 citation statements)

References 2 publications

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“…Once the ICT is confirmed and the patient is stable, the team must be ready for open evacuation while quickly preparing for a PC. The literature does not support the validity of expectant management [2] or coil embolization [21] as the reports were anecdotal experiences. In any unstable patient diagnosed with ICT, an urgent OD will be lifesaving.…”

Section: Discussionmentioning

confidence: 97%

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Iatrogenic cardiac tamponade as a mortal complication of peri-hiatal surgery. Analysis of 30 published cases

Çalıkoğlu¹,

Özgen²,

Toydemir³

et al. 2019

Heliyon

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Iatrogenic cardiac tamponade (ICT) is a dreadful complication of peri-hiatal surgery and vast majority occur during a hernia repair. Strikingly, against all warnings, the incidents and related deaths seem to be increasing. The aim of this review is to provide insight on how to prevent and challenge ICT. PubMed search identified 30 distinct ICTs with 10 deaths (33.3%) due to peri-hiatal procedures. Twenty-nine operations were mechanical repairs and laparoscopic anti-reflux surgery was the primary cause (n:18). Graft fixation (n:23) and helical tacks (n:13) were the main offenders. Initial symptom was hypotension affecting 92%. Seven ICTs were only identified at autopsy. All treated patients except one underwent a drainage. Almost all ICTs were caused by injury to the diaphragmatic dome, anterior to hiatus. In conclusion, peri-hiatal surgery-related ICT is extremely fatal. ICT mainly occurs during the repair of a hernia, a benign condition and therefore must be prevented. Graft fixation, around the ante-hiatal diaphragmatic dome must be abandoned. If mesh-augmentation is absolutely necessary, meticulous stitching must be preferred instead of fixators. Persistent hypotension during or following a peri-hiatal operation is an alarming sign of ICT. Increased awareness is mandatory for prevention and survival.

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Section: Discussionmentioning

confidence: 97%

“…Repair of hiatal [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15], ventral [3, 9, 16, 17] and diaphragmatic hernias [18, 19, 20] with mesh-augmentation resulted in ICT and deaths. ICTs during peri-hiatal surgery unrelated to graft fixation were also reported [13, 21, 22, 23, 24, 25, 26].…”

Section: Introductionmentioning

confidence: 99%

Iatrogenic cardiac tamponade as a mortal complication of peri-hiatal surgery. Analysis of 30 published cases

Çalıkoğlu¹,

Özgen²,

Toydemir³

et al. 2019

Heliyon

View full text Add to dashboard Cite

show abstract

“…In the present case, the patient was initially assessed by a non-surgical rapid response team who recommended CT scan to rule out abdominal hemorrhage. Bedside echocardiography was initiated by the surgical team on their arrival leading to the diagnosis; indeed, CT scan in this situation may have had catastrophic consequences as previously reported [12] .…”

Section: Discussionmentioning

confidence: 86%