Late Gastric Perforations After Laparoscopic Fundoplication

Huguet, Kevin L.; Hinder, Ronald A.; Berland, Todd

doi:10.1007/s00464-007-9367-9

Cited by 3 publications

(3 citation statements)

References 14 publications

(9 reference statements)

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“…In the literature, cases of gastric herniation and perforation after Nissen fundoplication have been reported in the late postoperative second week. [1,8] However, in our case, the complaints started on the postoperative third day, and the gastric perforation occurred on the postoperative fifth day. The dysphagia and abdominal pain, which started on postoperative third day, were considered to be the result of the herniation of the gastric wrap into the chest.…”

Section: Discussionmentioning

confidence: 49%

“…[7] Incarceration, strangulation, and perforation may occur in conjunction with wrap herniation, and all reported cases of gastric perforations after laparoscopic Nissen fundoplication have been caused by this condition. [1] According to Huguet, [8] possible mechanisms responsible for these gastric perforations include full-thickness ulceration caused by the suture material or the use of Teflon pledgets to secure the fundoplication, whereas the presumed cause has been late herniation associated with ischemia. In the literature, cases of gastric herniation and perforation after Nissen fundoplication have been reported in the late postoperative second week.…”

Section: Discussionmentioning

confidence: 99%

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Early intrathoracic herniation and rupture of the stomach after laparoscopic Nissen fundoplication

Karasu¹

2013

Turk Gogus Kalp Dama

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Plike edilen midenin toraks içine herniasyonu laparoskopik Nissen fundoplikasyonunun bilinen bir komplikasyonu olmakla birlikte, perforasyonu oldukça seyrektir. Bu yazıda, laparoskopik Nissen fundoplikasyonu uygulanan ve plike edilen midenin toraks içi herniasyonu ve perforasyonu gelişen 30 yaşında bir erkek olgu sunuldu. Hasta ameliyat sonrası beşinci gün şiddetli bulantı, ateş, kusma ve göğüs ağrısı yakınması ile acil servise başvurdu. Radyolojik ve endoskoskopik incelemede plike edilen midenin toraks içi herniasyonu ve rüptürü ortaya konuldu. Sol torakofrenotomi ile mide primer tamir edilerek, tekrar karın boşluğuna yerleştirildi. Anah tar söz cük ler: Herniasyon; Nissen fundoplikasyonu; perforasyon. Although intrathoracic gastric herniation of a fundoplication wrap is a well-known complication of laparoscopic Nissen fundoplication, perforation is quite rare. In this article, we report a 30-year-old male case who underwent a laparoscopic Nissen fundoplication complicating an intrathoracic gastric herniation and perforation of the fundoplication wrap. He was admitted to the emergency department with severe vomiting, fever, nausea and chest pain at postoperative fifth day. Radiological and endoscopic examination revealed intrathoracic wrap herniation and rupture of the stomach. The perforation was primarily repaired and the stomach was placed back to the abdominal cavity through left thoracophrenotomy.

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Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Early intrathoracic herniation and rupture of the stomach after laparoscopic Nissen fundoplication

Karasu¹

2013

Turk Gogus Kalp Dama

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“…GD ischemia has been reported sparsely in acute aortic dissection (13), aortic coarctation (in newborn) (14), acute pancreatitis with pancreatic pseudocyst, hernia (hiatal, paraesophageal and diaphragmatic hernia) (15), small bowel obstruction (16), massive gastric dilatation (17), post endoscopic submucosal dissection of early gastric cancer (18), post laparoscopic fundoplication (19), postoperative conditions (distal pancreatectomy with celiac axis resection, subtotal gastrectomy, highly selective vagotomy, splenectomy, gastric restrictive procedure using staplers, esophageal surgery) (20, 21) and cocaine abuse (22). …”

Section: Introductionmentioning

confidence: 99%

The significance of gastric and duodenal histological ischemia reported on endoscopic biopsy

J¹,

Chavalitdhamrong²,

Jensen³

et al. 2011

Endoscopy

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It is unknown whether pathological reports of ischemia obtained from gastroduodenal biopsy suggests a diagnosis, prognosis or requires additional evaluation. The aim of this study was to review the natural history, clinical presentation, endoscopic appearance, treatments and major clinical outcomes of patients with gastroduodenal ischemia. Case series of fourteen patients with variable etiologies, seven patients with gastric and seven patients with duodenal origin were obtained from a search of our endoscopic pathologic database for reports of histological ischemia. The most common indication for upper endoscopy was upper gastrointestinal bleeding (71%). Half of the endoscopic lesions appeared very severe. There were six cases of rebleeding (43%) and four deaths (29%). CT scanning was frequently used (12 cases, 86%), but was diagnostic in only three cases. Patients with underlying vascular pathology have substantial 6-month mortality (29%).

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Laparoscopic management of a late gastric perforation post-fundoplication

Keilig

Shariff

2020

Journal of Surgical Case Reports

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Nissen fundoplication is a safe and effective procedure for gastroesophageal reflux. Gastric ulceration leading to perforation is an uncommon late complication with a mechanism of action that is poorly understood. A 40-year-old male presented 3 years following his fundoplication with a perforated ulcer in the upper body of the stomach. The patient admitted ibuprofen use leading up to the perforation. The perforation was successfully repaired via laparoscopy, with good postoperative outcome. Gastric ulcer perforation post-fundoplication is a rare late outcome. Gastric perforation may have been precipitated by the use of non-steroidal anti-inflammatory drugs (NSAIDs) in concert with the vascular mechanical changes caused by this procedure. A review of the literature reveals only a handful of accounts of gastric ulcers or perforations as a late outcome. Of note, many of these perforations occur in the upper stomach and in tandem with NSAID use.

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Late Gastric Perforations After Laparoscopic Fundoplication

Abstract: This series of late gastric fundal perforations in 0.2% of our patients after laparoscopic fundoplication may have been caused by medications, gastric stasis, ischemia, or a foreign body such as a stitch or Teflon pledget.

Cited by 3 publications

References 14 publications

Early intrathoracic herniation and rupture of the stomach after laparoscopic Nissen fundoplication

Early intrathoracic herniation and rupture of the stomach after laparoscopic Nissen fundoplication

The significance of gastric and duodenal histological ischemia reported on endoscopic biopsy

Laparoscopic management of a late gastric perforation post-fundoplication

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