Abstract
Background
Gastric necrosis after Nissen fundoplication is a rare and life-threatening complication described in paediatric surgery and in some experimental models. Prompt diagnosis and appropriate therapy of acute gastric dilatation is mandatory to avoid potentially fatal gastric necrosis.
Case report
This case report is the first one to describe a gastric necrosis in an adult as a late and very severe complication after Nissen fundoplication. Gastric dilatation and subsequent necrosis occurred 14 years after Nissen fundoplication because of small bowel obstruction based on adhesions.
Conclusion
Early diagnosis and treatment of gastric dilatation after Nissen fundoplication are essential to prevent from severe secondary complications but can be difficult to establish because of atypical symptoms.
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References
Hocking MP, Maher JW, Woodward ER (1982) Definitive surgical therapy for incapacitating “gas-bloat” syndrome. Am Surg 48:131–133
Ferguson MK (1995) Open Nissen fundoplication. Chest Surg Clin N Am 5:379–394
Nissen RR (1963) Chirurgie der kadia. Ciba Symp 11:195–223
Idowu J, Razzouk AJ, Georgeson K (1987) Visceral ischemia secondary to gastric dilatation: a rare complication of Nissen fundoplication. J Pediatr Surg 22:939–940
Glick PL, Harrison MR, Adzick NS, Webb HW, DeLorimier AA (1987) Gastric infarction secondary to small bowel obstruction: a preventable complication after Nissen fundoplication. J Pediatr Surg 22:941–943
Todd SR, Marshall GT, Tyroch AH (2000) Acute gastric dilatation revisited. Am Surg 66:709–710
Cho KC, Kratka P, Baker SR (1988) Complete obstruction of gastroesophageal junction from acute gastric dilatation in a patient with a Nissen fundoplication. Am J Gastroenterol 83:1165–1167
Reeve T, Jackson B, Scott-Conner C, Sledge C (1988) Near-total gastric necrosis caused by acute gastric dilatation. South Med J 81:515–517
Edlich RF, Borner JW, Kuphal J, Wangensteen OH (1970) Gastric blood flow. I. Its distribution during gastric distention. Am J Surg 120:35–37
Acknowledgments
We thank Novartis, Basel, Switzerland, for providing us the illustration in Fig. 3. No conflicts of interest. No financial interests to disclose.
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Patuto, N., Acklin, Y., Oertli, D. et al. Gastric necrosis complicating lately a Nissen fundoplication. Langenbecks Arch Surg 393, 45–47 (2008). https://doi.org/10.1007/s00423-007-0216-z
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DOI: https://doi.org/10.1007/s00423-007-0216-z