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Peer-reviewedCC BY-NC-NDJournal of cardiothoracic surgery

Delayed intrathoracic closed-loop small bowel obstruction due to iatrogenic diaphragmatic hernia two years after subxiphoid pericardial window: a case report.

  • Gladys Bruyninx1,2
  • Basil Nasir3,4
4 affiliations
  1. 1General Surgery Division, Department of Surgery, University of Montreal, Montreal, Canada. [email protected].
  2. 2General Surgery, University of Montreal, 1000 Saint Denis St, Montreal, H2X 0C1, Quebec, Canada. [email protected].
  3. 3Chirurgie Thoracique, Department of Surgery, Centre Hospitalier de l'Université de Montréal, Montréal, Canada.
  4. 4General Surgery, University of Montreal, 1000 Saint Denis St, Montreal, H2X 0C1, Quebec, Canada.
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Abstract

Background

Diaphragmatic hernia following pericardial window is a rare complication, typically presenting in the early postoperative period. Delayed presentation with intrathoracic closed-loop small bowel obstruction is exceedingly uncommon (1,2).Case presentation

A 74-year-old male presented with nausea, vomiting, abdominal distension, and epigastric pain two years after a subxiphoid pericardial window for recurrent pericardial effusion. Computed tomography demonstrated herniation of small bowel into the thoracic cavity through a diaphragmatic defect with features of closed-loop obstruction. The patient underwent urgent exploratory laparotomy, which confirmed viable small bowel herniated into the thoracic cavity. The bowel was reduced without resection, and the diaphragmatic defect was repaired using Gore-Tex mesh. The postoperative course was uneventful.Conclusion

Delayed diaphragmatic hernia after pericardial window is a rare but potentially life-threatening complication. This case underscores the importance of maintaining a high index of suspicion in patients presenting with obstructive symptoms, even years after the initial procedure (3,4).

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Cite

BibTeXRIS
BibTeX
@article{bruyninx2026delayed,
  title = {{Delayed intrathoracic closed-loop small bowel obstruction due to iatrogenic diaphragmatic hernia two years after subxiphoid pericardial window: a case report.}},
  author = {Gladys Bruyninx and Basil Nasir},
  journal = {Journal of cardiothoracic surgery},
  year = {2026},
  month = jul,
  doi = {10.1186/s13019-026-04627-3},
  url = {https://europepmc.org/article/MED/42897571},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Delayed intrathoracic closed-loop small bowel obstruction due to iatrogenic diaphragmatic hernia two years after subxiphoid pericardial window: a case report.
AU  - Gladys Bruyninx
AU  - Basil Nasir
PY  - 2026
DA  - 2026/07/01
JO  - Journal of cardiothoracic surgery
DO  - 10.1186/s13019-026-04627-3
UR  - https://europepmc.org/article/MED/42897571
AB  - Background  Diaphragmatic hernia following pericardial window is a rare complication, typically presenting in the early postoperative period. Delayed presentation with intrathoracic closed-loop small bowel obstruction is exceedingly uncommon (1,2).Case presentation  A 74-year-old male presented with nausea, vomiting, abdominal distension, and epigastric pain two years after a subxiphoid pericardial window for recurrent pericardial effusion. Computed tomography demonstrated herniation of small bowel into the thoracic cavity through a diaphragmatic defect with features of closed-loop obstruction. The patient underwent urgent exploratory laparotomy, which confirmed viable small bowel herniated into the thoracic cavity. The bowel was reduced without resection, and the diaphragmatic defect was repaired using Gore-Tex mesh. The postoperative course was uneventful.Conclusion  Delayed diaphragmatic hernia after pericardial window is a rare but potentially life-threatening complication. This case underscores the importance of maintaining a high index of suspicion in patients presenting with obstructive symptoms, even years after the initial procedure (3,4).
SN  - 1749-8090
ER  -