S2557 Endoscopic Treatment of Gastric Perforation Resulting From Slipped Nissen Fundoplication

Abstract 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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Gastric Perforation and Pancreatitis Manifesting after an Inadvertent Nissen Fundoplication in a Patient with Superior Mesenteric Artery Syndrome

Case Reports in Medicine ◽

10.1155/2009/426162 ◽

2009 ◽

Vol 2009 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

Mikael Petrosyan ◽

Joaquin J. Estrada ◽

Stefano Giuliani ◽

Monica Williams ◽

Heather Rosen ◽

...

Keyword(s):

Small Bowel ◽

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Clinical Symptoms ◽

Nissen Fundoplication ◽

Gastric Perforation ◽

Radiological Findings ◽

Severe Morbidity ◽

Sma Syndrome ◽

Proximal Small Bowel

Superior mesenteric artery (SMA) syndrome is an uncommon but well-recognized clinical entity. It can lead to proximal small bowel obstruction and severe morbidity and mortality in lieu of late diagnosis and concomitant existing comorbidities. We report a 54-year-old female, with SMA syndrome which manifested itself after Nissen fundoplication along with two major complications. The diagnosis of SMA was established by clinical symptoms and radiological findings.

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Current standards for assessing pregnancy status before surgery are subjective and should be replaced with definitive, objective evidence

Scottish Medical Journal ◽

10.1177/0036933018760766 ◽

2018 ◽

Vol 63 (2) ◽

pp. 60-62 ◽

Cited By ~ 2

Author(s):

Keiran D Clement ◽

Andreas Luhmann ◽

Michael SJ Wilson ◽

Pradeep Patil

Keyword(s):

Abdominal Pain ◽

Diagnostic Laparoscopy ◽

Nissen Fundoplication ◽

Gastric Perforation ◽

Gravid Uterus ◽

Objective Evidence ◽

Pregnancy Status ◽

Laparoscopic Nissen ◽

Current Guidelines ◽

Current Standards

We report a case of a young woman admitted electively for laparoscopic Nissen fundoplication, and again three days post-operatively as an emergency with profuse vomiting and abdominal pain. She underwent diagnostic laparoscopy, and a small gastric perforation was found at the site of the fundoplication and this was suture-repaired. On both admissions, she was “screened” for pregnancy as per current guidelines. On the second admission, following a CT scan, she was found to have a gravid uterus with a foetus of 16–18 weeks’ gestation. In the opinion of the authors, this case highlights that current National Institute for Health and Care Excellence guidelines may be insufficient and could lead to unnecessary harm either to mother or foetus pre-, peri- or post-operatively.

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Rare Case of Endoscopic Treatment for Bevacizumab-Related Gastric Perforation in a Patient with Ovarian Cancer

Chemotherapy ◽

10.1159/000508556 ◽

2020 ◽

Vol 65 (1-2) ◽

pp. 54-57 ◽

Cited By ~ 1

Author(s):

Serena Cappuccio ◽

Benito Marinucci ◽

Vincenzo Bove ◽

Luigi Carlo Turco ◽

Francesco Cosentino ◽

...

Keyword(s):

Ovarian Cancer ◽

Surgical Treatment ◽

Clinical Condition ◽

Clinical Management ◽

Endoscopic Treatment ◽

Rare Case ◽

Gastric Perforation ◽

Advanced Ovarian Cancer ◽

Adjuvant Setting ◽

Endoscopic Suturing

Antiangiogenic chemotherapy is a common treatment option for patients with advanced ovarian cancer (OC) and has been proven to be effective and generally safe. Nevertheless, in rare cases, these drugs can give serious complications such as gastrointestinal perforations that can be even mortal or very difficult to treat and can heavily impact the clinical management. We present a rare case of bevacizumab-induced gastric perforation in a patient with advanced OC occurred during bevacizumab-including chemotherapy in an adjuvant setting. Surgical treatment was not possible due to the frailty of the clinical condition of the patient and the gastric perforation was successfully treated with endoscopic suturing.

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