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Cecal herniation through the foramen of Winslow after laparoscopic Nissen fundoplication
T D Samson1, F M Tercero, K Sato
1Department of Surgery, Creighton University School of Medicine, St. Joseph Hospital, 601 N. 30th Street, Suite 3740, Omaha, Nebraska 68131-2197, USA.
Laparoscopic Nissen fundoplication is the treatment of choice for medically refractive gastroesophageal reflux disease. Cecal herniation is an exceedingly rare complication of this procedure. We report the case of a 51-year-old woman who presented 2 months after a successful laparoscopic Nissen fundoplication with heartburn and epigastric pain that radiated to her back. Abdominal films showed an air-filled loop in the left upper quadrant. At surgery, the patient had a redundant loop of cecum, which had herniated through the foramen of Winslow over the stomach and was positioned beneath the left hemidiaphragm. The cecum was not ischemic. A right hemicolectomy was performed to prevent recurrence. The patient recovered fully and has had no further problems. This is the first report of such a case.
Laparoscopic Nissen fundoplication is the treatment of choice for medically refractive gastroesophageal reflux disease. Cecal herniation is an exceedingly rare complication of this procedure. We report the case of a 51-year-old woman who presented 2 months after a successful laparoscopic Nissen fundoplication with heartburn and epigastric pain that radiated to her back. Abdominal films showed an air-filled loop in the left upper quadrant. At surgery, the patient had a redundant loop of cecum, which had herniated through the foramen of Winslow over the stomach and was positioned beneath the left hemidiaphragm. The cecum was not ischemic. A right hemicolectomy was performed to prevent recurrence. The patient recovered fully and has had no further problems. This is the first report of such a case.
