Left shoulder pain during meals: a rare complication after laparoscopic Toupet procedure in children

An uncommon complication of laparoscopic Toupet procedure is reported. A 13-year-old girl, with symptoms of gastro-esophageal reflux disease for many years, including esophagitis detected by gastro-esophageal endoscopy, underwent laparoscopic fundoplication. Ten days after the procedure, isolated episodes of pain localized to the left shoulder appeared during meals. No dysphagia, chest pain, or heartburn was associated with this pain. All explorations (including abdomino-thoracic computed tomography, endoscopy, barium meal, Ph-metry) were negative. Six months after the operation, symptoms remained identical. We hypothesized that the left wrap fixation on diaphragm could be causing the pain by traction during gastric filling. By laparoscopy, we cut just 1 stitch which fixed the wrap to the diaphragm. Three days after this procedure symptoms definitively disappeared with a current follow-up of 10 months.