Abstract：
Laparoscopic intraperitoneal onlay mesh repair is favoured for diaphragmatic hernias due to better outcomes. However, fixation devices pose risks, including cardiac tamponade. A man underwent laparoscopic repair for a large diaphragmatic hernia. One week later, he presented with chest discomfort which was initially attributed to postoperative pain. Subsequently, patient represented with worsening of chest pain and tachycardia. CT requested to rule out pulmonary embolism revealed a large pericardial effusion. Urgent drainage via apical approach resolved tamponade. The case highlights the challenges in managing pericardial effusions post-laparoscopy in the presence of diaphragmatic mesh and stresses multidisciplinary collaboration. Literature review highlights risks associated with fixation devices. Suggestions include limiting their use near vital structures. Key learning point of this case report is to raise awareness of cardiac tamponade following diaphragmatic hernia repair. Limited evidence necessitates cautious use of fixation devices, emphasising patient safety.
摘要：
腹腔镜腹膜内嵌式网片修复术对膈疝的治疗效果较好。然而,固定装置构成风险，包括心脏填塞.一名男子接受了腹腔镜修复术治疗大型膈疝。一周后,他出现胸部不适，最初归因于术后疼痛。随后，患者表现为胸痛和心动过速恶化。要求排除肺栓塞的CT显示大量心包积液。通过根尖法紧急引流解决了填塞。该病例突出了在存在diaphragm网的情况下腹腔镜检查后处理心包积液的挑战，并强调了多学科合作。文献综述强调了与固定装置相关的风险。建议包括限制在重要结构附近使用。该病例报告的关键学习点是提高对膈疝修补术后心脏填塞的认识。有限的证据需要谨慎使用固定装置，强调患者安全。
