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Case report
Large mediastinal haematoma after paraoesophageal hernia repair
  1. Tim Finnegan1,
  2. Nicholas MacDonald2,
  3. Thomas Gianis1 and
  4. Christopher Senkowski1
  1. 1Surgery, Memorial University Medical Center, Savannah, Georgia, USA
  2. 2Mercer University School of Medicine, Macon, Georgia, USA
  1. Correspondence to Dr Tim Finnegan; tmfinnegan1{at}


Mediastinal haematoma is a rare complication of laparoscopic paraoesophageal hernia repair with few documented cases in the current literature. Presentation of this unique clinical problem can range from extrinsic oesophageal obstruction to life-hreatening cardiac tamponade and therefore, warrants further discussion of at-risk population aetiology, diagnosis and successful management strategies. We present the case of a 71-year-old woman who underwent laparoscopic paraoesophageal hernia repair with nissen fundoplication complicated by severe dysphagia on postoperative day 12. Further evaluation with oesophagram and CT imaging revealed a large mediastinal haematoma with near obstruction of the distal oesophagus. This was managed successfully with laparoscopic transhiatal washout and drainage.

  • gastro-oesophageal reflux
  • general surgery
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  • Contributors All authors are aware of this submission. TF is the corresponding author and was actively involved in the patient care and case write up along with TG. CS was the attending physician for the case. NM helped with formatting and submission of the case as well as patient consent.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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