Migración de funduplicatura gástrica con perforación intratorácica

Authors

  • Fernando Alcaide Hospital General Mateu Orfila
  • Hernán Giordano
  • Ildefonso Campano Cruz
  • Alejandro Fernández Alonso
  • Maurizio Meus
  • Alberto Gil Iriondo
  • Claudia Bagur Bagur

DOI:

https://doi.org/10.22307/2603.8706.2020.02.003

Abstract

The laparoscopic antireflux surgery is considered the gold standard for the treatment of gastroesophageal reflux disease and hiatal hernia. The postoperative results show a low associated morbidity and mortality and good satisfaction in the medium long term.

         We present the clinical case of a 53-year-old patient who underwent Nissen-Rossetti laparoscopic fundoplication who, on the twelfth postoperative day, presented with mediastinitis associated with sepsis due to intrathoracic perforation of the gastric fundoplication migrated to the chest. The patient was operated on urgently, performing thoracic drainage, supra-umbilical median laparotomy and primary closure of the perforation. The postoperative period is characterized by a 23-day stay in the intensive care unit and by necrotizing pneumonia, lung abscesses, and left pleural empyema. Ten years after the episode, the patient is asymptomatic and has no signs of clinical recurrence.

         Although the incidence of early complications in antireflux surgery is relatively low, it is mandatory to suspect them in a patient with sepsis due to mediastinitis and recent surgery. In front of extremely serious situations, it is necessary to intervene urgently, although the surgical re-exploration of the hiatus is considered a complex surgery with a high risk of iatrogenesis.

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Author Biography

Fernando Alcaide, Hospital General Mateu Orfila

Hospital General Mateu Orfila

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Published

2020-10-29

How to Cite

Alcaide, F., Giordano, H., Campano Cruz, I., Fernández Alonso, A., Meus, M., Gil Iriondo, A., & Bagur Bagur, C. (2020). Migración de funduplicatura gástrica con perforación intratorácica. Annals of Mediterranean Surgery, 3(2). https://doi.org/10.22307/2603.8706.2020.02.003

Issue

Vol. 3 No. 2 (2020)

Section

Case Report

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