[Dysphagia and dyspnea after laparoscopic fundoplication]

Area of Science:

• Gastroenterology
• Surgical Innovation
• Thoracic Surgery

Background:

• Laparoscopic antireflux surgery is a common procedure for gastroesophageal reflux disease.
• Intrathoracic gastric herniation is a known, albeit rare, complication following this surgery.
• Herniation can manifest in both early and late postoperative phases.

Observation:

• A patient presented with early-onset dysphagia attributed to a tight wrap after surgery.
• Symptoms progressed to include vomiting and worsening dysphagia due to gastric herniation.
• Gastroscopy and bougienage were performed, leading to the development of tension pneumothorax.

Findings:

• The case highlights a complex scenario involving early intrathoracic gastric herniation post-laparoscopic antireflux surgery.
• A tight wrap contributed to initial dysphagia, with herniation exacerbating symptoms.
• Iatrogenic tension pneumothorax occurred as a complication of diagnostic/therapeutic intervention.

Implications:

• This case underscores the importance of recognizing and managing gastric herniation after antireflux procedures.
• Prompt diagnosis and appropriate intervention are vital to avoid severe complications.
• Understanding the relationship between surgical technique, herniation, and potential iatrogenic events is critical for patient safety.