Cardiac tamponade as a life-threatening complication in antireflux surgery.

BACKGROUND: While injuries to the esophagus, stomach, spleen and pleura are well-known, cardiac lesions resulting from complications of surgery at the esophagogastric junction are rarely reported in the literature. METHODS: We report on two of our own patients with cardiac tamponade after surgery at the esophagogastric junction and present a review of the literature. RESULTS: We overview seven patients (including our own). In five cases a stitch to the diaphragm was the cause. The lesions became apparent during and up to fourteen days after the operation. In three cases the complication led to death. CONCLUSIONS: It is essential to consider the risk of cardiac lesions with surgery at the esophagogastric junction, especially if sutures or staples are placed in this region. Only with an appropriate alertness and management can this complication be prevented and its potentially fatal issue averted.

A severe complication after laser-induced damage to a transtracheal catheter during endoscopic laryngeal microsurgery.

UNLABELLED: Subcutaneous emphysema and pneumothorax is a rare and severe complication of percutaneous transtracheal jet ventilation, usually caused by obstruction of the upper airway or displacement of the tracheal catheter. Nevertheless, it is our preferred technique for endoscopic laryngeal laser surgery. We report a patient with acute subcutaneous emphysema and pneumothorax during laser surgery, caused by unobserved laser damage and discuss the associated risk factors. IMPLICATIONS: The percutaneous transtracheal jet ventilation for elective laryngeal laser surgery reduces the risk of airway fires and gives a free endoscopic operative field. This case report suggests that, even when using a teflon catheter, laser-induced damage with severe complications might occur.