Extrapericardial tamponade with herniated omentum after transhiatal esophagectomy

Abstract

An unusual complication following transhiatal esophagectomy for lower esophageal carcinoma is reported in which extrapericardial tamponade and profound shock occurred secondary to a herniated section of omentum in the immediate postoperative period. The two-dimensional echocardiogram was nondiagnostic, but the diagnosis was confirmed during reexploration of the abdomen. Anatomic and pathophysiologic considerations of this unusual but life-threatening complication are discussed. The literature suggests that computed tomography is the study of choice to confirm the clinical diagnosis of pericardial pathology, and this case report is yet another example to support routine closure of the esophageal aperture.

Diaphragmatic herniation after esophagectomy for carcinoma of the esophagus: a report of two cases

“…In our institution, the mediastinal route is preferred after esophagectomy, and incidence of diaphragmatic herniation after esophagectomy was 1% (2/168). To date, 30 cases of diaphragmatic herniation after esophagectomy for carcinoma of the esophagus have been reported in the English-language literature (Table 1) [2][3][4][5][6][7][8][9][10][11][12][13]. Our reports of diaphragmatic herniation after esophagectomy are, to our knowledge, the fi rst from Japan in the English-language literature.…”

Extrapericardial cardiac compression syndrome

“…Furthermore, cases of isolated left atrial compression resulting in respiratory symptoms have been reported in association with a variety of mediastinal pathology, including bronchogenic cysts, carcinomas, thymomas, and aortic aneurysms [16]. Gastroesophageal conditions, such as hiatal hernias with gastric volvulus [17,18] and two reports of herniated omentum [19], have led to extrapericardial cardiac compression post-operatively.…”

Diaphragmatic herniation after transhiatal esophagectomy

“…Granke et al . have observed omental herniation through the hiatus 7days after surgery 7 . Katariya et al.…”