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Related Experiment Videos

[Intestinal obstruction after Nissen's fundo-plication].

Y Heloury1, B Savigny, M Baron

  • 1Service de Chirurgie Infantile, Hôtel Dieu, Nantes.

Journal De Chirurgie
|December 1, 1991
PubMed
Summary

Nissen fundoplication for reflux can cause severe obstruction, a rare but life-threatening complication. This surgical risk, leading to intestinal ischemia and death in most cases, requires careful patient counseling and specific surgical techniques.

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Area of Science:

  • Gastroenterology
  • Pediatric Surgery
  • Surgical Complications

Background:

  • Nissen fundoplication is a primary surgical treatment for gastroesophageal reflux.
  • While effective, it carries risks including dysphagia and gas bloat syndrome.
  • Intestinal obstruction is a rare but severe complication of this procedure.

Observation:

  • This report details 6 cases of Nissen fundoplication complications.
  • Four cases involved children with prior esophageal atresia or severe apnea.
  • Two adult cases presented with gastric perforation post-fundoplication.

Findings:

  • Three pediatric cases experienced fatal intestinal ischemia within hours of obstruction.
  • One child required emergent gastric tube insertion and later re-operation.

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  • Adults presented with gastric perforation at 7 days and 9 months post-surgery, with one fatality.
  • Overall mortality was 4 out of 6 cases.

    • Implications:

    • Nissen fundoplication complications, particularly obstruction, have high morbidity and mortality.
    • Emergent gastric tube insertion can decompress the digestive tract but may not prevent recurrence.
    • Informed consent regarding obstruction risks is crucial for patients and parents.
    • Preventive surgical strategies include a submesocolic approach avoiding small bowel exposure.