Pericardial Effusion Can Be a Critical Complication After Laparoscopic Hernia Repair Using Mesh and Stapler for Morgagni Hernia

Abstract

Several cases of Morgagni hernia have recently been treated with laparoscopic mesh repair, which is reported to have fewer complications and to be less invasive. Here we describe a case of a laparoscopic Morgagni hernia repair treated with mesh that progressed to heart failure due to pericardial effusion 2 months after hospital discharge. A 78-year-old woman was incidentally found to have a Morgagni hernia during a routine chest X-ray. The laparoscopic Morgagni hernia repair was performed using Composix mesh and an ENDOPATH EMS stapler. The Composix mesh was gently attached to the surface of the diaphragm using the ENDOPATH EMS stapler. She was discharged from the hospital on the seventh postoperative day without any adverse events. However, 2 months later, she developed dyspnea due to heart failure secondary to a pericardial effusion. Pericardial drainage was performed during her hospitalization, and she was discharged 7 days later. No recurrence of either the pericardial effusion or the Morgagni hernia has been detected since the pericardial drainage. Clinicians may need to be aware of the risk of pericardial effusion in these cases, even if there has been no damage to the diaphragm or epicardium.