risk factors for the onset of GUs. Furthermore, there are reports on the importance of protecting the vagus nerve. Local ischemia in the upper part of the lesser curvature and mechanical trauma were also involved in the onset of ulcers. The eradication of H. pylori may be an effecti- ve therapeutic mean to prevent GUs after fundoplication (4). After all, the mechanism may be multifactorial. In our case, a deep and wide cardia ulcer appeared after laparoscopic fundoplication and proved to be refractory to proton pump inhibitors, antacids and H. pylori eradica- tion. Trauma of the vagus nerve and local ischemia may have been the causative factors. To prevent perforation, the patient underwent subtotal gastrectomy. This case represents a typical ‘GU due to laparoscopic fundoplication’, and the preoperative gastroscopy reve- aled no sign of ulcer or malignancy there. Efforts were wasted in search of a malignant ulcer. A gastroentero- logist must take a careful medical history before perfor- ming any diagnostic effort, and the diagnosis ‘GU due to laparoscopic fundoplication’ must be called to mind in a similar setting
Corresponding author: Ahmet Burak TOROS Emek Mah. Ordu Cad. KentLife Sitesi, A1-3 Blok, D: 30, Sancaktepe, İstanbul, Türkiye • Tel: +90-535 783 58 29 Fax: +90-216 999 05 82 E-mail: aburaktoros@yahoo.com
Primary Language | Turkish |
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Journal Section | Articles |
Authors | |
Publication Date | December 1, 2013 |
Published in Issue | Year 2013 Volume: 12 Issue: 3 |
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