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Intrathoracic herniation and perforation 18 years after open Nissen fundoplication
J S Danetz1, A M Jayawant, J B Dattilo
1Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0068, USA.
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|November 9, 2000
Summary
Nissen fundoplication, a common surgery for acid reflux, can rarely lead to gastric perforation years later. This case highlights a unique intrathoracic gastric wrap perforation and its potential causes long after the initial operation.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Medical Case Reports
Background:
- Nissen fundoplication is a standard surgical treatment for gastroesophageal reflux disease (GERD).
- Complications like esophageal and gastric perforations are typically seen perioperatively.
- Long-term complications, especially delayed perforations, are less understood.
Observation:
- A unique case of intrathoracic gastric wrap perforation is presented.
- The perforation occurred nearly two decades after the initial Nissen fundoplication surgery.
- This delayed complication occurred in the absence of typical perioperative risk factors.
Findings:
- The study details the clinical presentation and diagnostic process for this rare delayed perforation.
- Suspected pathophysiology involves chronic mechanical stress and tissue degradation of the gastric wrap.
- Endoscopic and imaging findings are discussed in relation to the perforation.
Implications:
- This case expands the understanding of potential long-term complications following Nissen fundoplication.
- It suggests that chronic mechanical factors can lead to gastric wrap integrity loss.
- Awareness of such rare delayed presentations is crucial for patient management and follow-up.
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