Two Cases of Laparoscopic Resection of Siewert Type II Adenocarcinoma of the Esophagogastric Junction Using a Transhiatal Approach and Complicated by Hemopericardium

Sep 24, 2026

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Two cases describe laparoscopic transhiatal total gastrectomy for Siewert type II adenocarcinoma of the esophagogastric junction, followed by postoperative hemopericardium. Both patients presented shared cardiovascular compromise with tachycardia and low blood pressure, while imaging with color Doppler ultrasound and CT identified pericardial hemorrhagic effusion. Emergent ultrasound-guided pericardiocentesis and drainage led to rapid improvement of vital signs and uncomplicated recovery, without additional events. The report highlights postoperative hemopericardium as life-threatening and emphasizes prompt detection and ultrasound-guided intervention as an effective treatment strategy.

LanguageEnglish

CategoryHealthcare

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Pages5

Reading Time13 min

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Background

Case Reports

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e-ISSN 1941-5923 © Am J Case Rep, 2023; 24: e939376 DOI: 10. 12659/AJCR.939376 Received: 2022.12.29 Accepted: 2023.05.05 Available online: 2023.05.17 Published: 2023.06.16 Authors’ Contribution: Study Design A Data Collection B Statistical Analysis C Data Interpretation D Manuscript Preparation E Literature Search F Funds Collection G BC 1,2 BCD 1 BD 1 AD 3 D 1 A 1 C 1 B 1 AEFG 1 Corresponding Author: Financial support: Conflict of interest: Two Cases of Laparoscopic Resection of Siewert Type II Adenocarcinoma of the Esophagogastric Junction Using a Transhiatal Approach and Complicated by Hemopericardium Na Wang Longyin Ma Zhenguo Gao Shunying Liu Xiangzhi Qin Mingyang Ren Dan Bai Yong Peng Yunhong Tian 1 Department of General Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, Sichuan, PR China 2 Department of Clinical Medicine, North Sichuan Medical College, Nanchong, Sichuan, PR China 3 Department of Dermatology, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, PR China Yunhong Tian, e-mail: [drtianyunhong@126.com](drtianyunhong@126.com) This work was supported by the Foundation of Sichuan Medical Association [S21025], and the Bureau of Science & Technology Nanchong City [22JCYJPT0007] The author declares no conflicts of interest Case series Patients: Male, 67-year-old • Male, 69-year-old Final Diagnosis: Adenocarcinoma of the esophagogastric junction Symptoms: Tachycardia and low blood pressure Clinical Procedure: — Specialty: Gastroenterology and Hepatology Objective: Unusual clinical course Background: Siewert type II adenocarcinoma of the esophagogastric junction is located at the boundary of the distal esophagus and gastric cardia, and surgical resection is currently performed using open or laparoscopic methods. This report presents 2 cases of laparoscopic resection of Siewert type II adenocarcinoma of the esophagogastric junction using a transhiatal approach, complicated by hemopericardium. Case Reports: We present 2 patients diagnosed with Siewert type II esophagogastric junction cancer. A 67-year-old man had intermittent dull pain in the epigastrium without apparent cause for 10 months. A 69-year-old man had persistent dull pain in the middle and upper abdomen for more than 3 months and acid reflux after eating. Gastroscopy with pathological examination confirmed the diagnoses. The patients underwent laparoscopic transhiatal total gastrectomy according to the Japanese Gastric Cancer Treatment Guidelines 2018 (5th edition). Pathological analysis classified the cancers as T3N1M0 and T2N0M0, respectively. The patients’ cases were complicated with hemopericardium 18 h and 23 h after surgery, respectively. The shared clinical symptoms of the patients included tachycardia and low blood pressure. Cardiovascular color Doppler ultrasound and computed tomography (CT) were used to identify the hemopericardium. Following emergent ultrasound-guided pericardiocentesis and drainage, the vital signs of the patients improved. Both patients recovered well, and no other complications occurred. Conclusions: Hemopericardium is a life-threatening complication for patients with esophageal-gastric junction cancer who undergo transhiatal laparoscopic surgery. Quick detection and intervention for postoperative hemopericardium following laparoscopic transhiatal total gastrectomy are important. Ultrasound-guided pericardiocentesisand drainage is effective for the treatment of postoperative hemopericardium. Keywords: Pericardial Effusion • Laparoscopy • Esophagogastric Junction • Gastrectomy • Adenocarcinoma Full-text PDF: [https://www.amjcaserep.com/abstract/index/idArt/939376](https://www.amjcaserep.com/abstract/index/idArt/939376) 1499 — 8 14 Publisher’s note: All claims expressed in this article are solely those of the authors and do not necessarily represent those of t

FAQs

What disease and surgical approach are reported in these cases?

The report describes two cases of Siewert type II adenocarcinoma at the esophagogastric junction treated with laparoscopic transhiatal total gastrectomy.

What postoperative complication occurred, and how was it identified?

Both cases developed postoperative hemopericardium, identified using cardiovascular color Doppler ultrasound and computed tomography.

How was hemopericardium managed, and what was the outcome?

Emergent ultrasound-guided pericardiocentesis and drainage were performed, improving vital signs and leading to good recovery without additional complications.

Sep 24, 2026

Uploaded by James