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.