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Gastric ulceration after fundoplication: A complication to keep in mind

Year 2013, Volume: 12 Issue: 3, - , 01.12.2013

Abstract

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

References

  • 1- Laine S, Rantala A, Gullichsen R, et al. Laparoscopic vs conventional Nissen fundoplication: a prospective randomized study. Surg En- dosc 1997; 11: 441-4.
  • 2- Luostarinen M. Nissen fundoplication for reflux esophagitis. Ann Surg 1993; 217: 329-37.
  • 3- Bremner CG. Gastric ulcer after the Nissen fundoplication. S Afr Med J 1977; 1: 791.
  • 4- Omura N, Kashiwagi H, Yano F, et al. Gastric ulcer after laparo- scopic fundoplication for gastroesophageal reflux disease: signifi- cance of the eradication of Helicobacter pylori. Surg Laparosc En- dosc Percutan Tech 2007; 17(3): 193-6.
  • 5- Toros AB, Ince AT, Kesici B, et al. A new modified concomitant therapy for Helicobacter eradication in Turkey. Helicobacter 2011; 16(3): 225-8.
  • 6- Humphries LA, Hernandez JM, Clark W, et al. Causes of dissatisfac- tion after laparoscopic fundoplication: the impact of new symp- toms, recurrent symptoms and the patient experience. Surg Endosc 2013; 27: 1537-45.
  • 7- Manduch M, Rossiter JP, Depew WT, et al. Fatal hemorrhage from a gastroaortic fistula secondary to gastric ulceration associated with Nissen fundoplication and nonsteroidal anti-inflammatory drug use. Can J Gastroenterol 2008; 22(3): 299-302.
  • 8- Maher JW, Cerda JJ. The role of gastric stasis in the genesis of gastric ulceration following fundoplication. World J Surg 1982; 6: 794-9.

Fundoplikasyon sonrası gastrik ülser: Akılda tutulması gereken bir komplikasyon

Year 2013, Volume: 12 Issue: 3, - , 01.12.2013

Abstract

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

References

  • 1- Laine S, Rantala A, Gullichsen R, et al. Laparoscopic vs conventional Nissen fundoplication: a prospective randomized study. Surg En- dosc 1997; 11: 441-4.
  • 2- Luostarinen M. Nissen fundoplication for reflux esophagitis. Ann Surg 1993; 217: 329-37.
  • 3- Bremner CG. Gastric ulcer after the Nissen fundoplication. S Afr Med J 1977; 1: 791.
  • 4- Omura N, Kashiwagi H, Yano F, et al. Gastric ulcer after laparo- scopic fundoplication for gastroesophageal reflux disease: signifi- cance of the eradication of Helicobacter pylori. Surg Laparosc En- dosc Percutan Tech 2007; 17(3): 193-6.
  • 5- Toros AB, Ince AT, Kesici B, et al. A new modified concomitant therapy for Helicobacter eradication in Turkey. Helicobacter 2011; 16(3): 225-8.
  • 6- Humphries LA, Hernandez JM, Clark W, et al. Causes of dissatisfac- tion after laparoscopic fundoplication: the impact of new symp- toms, recurrent symptoms and the patient experience. Surg Endosc 2013; 27: 1537-45.
  • 7- Manduch M, Rossiter JP, Depew WT, et al. Fatal hemorrhage from a gastroaortic fistula secondary to gastric ulceration associated with Nissen fundoplication and nonsteroidal anti-inflammatory drug use. Can J Gastroenterol 2008; 22(3): 299-302.
  • 8- Maher JW, Cerda JJ. The role of gastric stasis in the genesis of gastric ulceration following fundoplication. World J Surg 1982; 6: 794-9.
There are 8 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Ahmet Burak Toros This is me

Beşir Kesici This is me

Buğra Tolga Konduk This is me

Publication Date December 1, 2013
Published in Issue Year 2013 Volume: 12 Issue: 3

Cite

APA Toros, A. B., Kesici, B., & Konduk, B. T. (2013). Fundoplikasyon sonrası gastrik ülser: Akılda tutulması gereken bir komplikasyon. Akademik Gastroenteroloji Dergisi, 12(3).

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