Fatal Hemorrhage from a Gastroaortic Fistula Secondary to Gastric Ulceration Associated with Nissen Fundoplication and Nonsteroidal Anti-Inflammatory Drug Use
2008 ◽
Vol 22
(3)
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pp. 299-302
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Keyword(s):
Drug Use
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Acute gastrointestinal hemorrhage from a gastroaortic fistula in the gastric fundoplication pouch is a rare complication of Nissen fundoplication. The present case reports a gastroaortic fistula secondary to gastric ulceration associated with prior Nissen fundoplication and nonsteroidal anti-inflammatory drug use. A 55-year-old man presented with massive hematemesis and died of exsanguination during emergency laparotomy. Recognition of factors that predispose a patient to gastric ulceration after fundoplication, including nonsteroidal anti-inflammatory drug use, is critical to arouse the high index of suspicion required to diagnose and manage this life-threatening complication.