Right hemothorax after a Nissen fundoplication

Nissen fundoplication is one of the most popular techniques for treatment of patients with gastroesophageal reflux. There may be several complications, some common to any laparotomy and others specific to the fundoplication. We have recently observed an unusual complication: a right hemothorax from a perforated fundoplication that had not herniated into the thorax. The absence of abdominal symptoms made the diagnosis difficult and delayed surgical therapy.