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Retroesophageal Fundic Wrap Incarceration: a Late Complication After Nissen Fundoplication
Margaret M. Mcguire*, Erik G. Lough, Donald R. Czerniach, John J. Kelly, Philip Cohen Surgery, University of Massachusetts, Worcester, MA
This video illustrates the laparoscopic treatment of a late retroesophageal fundic wrap incarceration in a patient who had undergone laparoscopic Nissen fundoplication. Our patient presented to the emergency room 3 years after a Nissen fundoplication with epigastric pain, back pain and early satiety. Imaging revealed gastric outlet obstruction. Endoscopy showed a friable mucosa with patchy necrosis. On laparoscopic exploration the fundic wrap was found incarcerated, due to rotation beyond 360 degrees through the retroesophageal space, and lying on top of the greater curve of the stomach. After dissection and reduction of the wrap the incarcerated portion was necrotic and required resection.
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