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J Thorac Cardiovasc Surg 2007;133:1676-1677
© 2007 The American Association for Thoracic Surgery

Brief Communication

Gastropericardial fistula after laparoscopic surgery for gastroesophageal reflux disease

^a Thoracic Surgery Department, Pasteur Hospital, Nice, France
^b Anesthesiology and Critical Care Department, St Roch Hospital, Nice, France.

Received for publication January 6, 2007; accepted for publication February 7, 2007.

^_* Address for reprints: Daniel Pop, MD, Thoracic Surgery Department, Pasteur Hospital, Building H1, 30 Avenue de la Voie Romaine 06002 Nice, France. (Email: danielpopch@yahoo.com).

The first 20% of the full text of this article appears below.

Since the 1990s, laparoscopic antireflux surgery has gained in popularity. Many studies have demonstrated the safety and efficacy of this minimal procedure. However, long-term failure rates and complications range from 4.5% to 12.5% in larger series.^1,2 Some of the postoperative complications are specific to laparoscopy. Paraesophageal hiatal hernia (PEHH), or "slipped wrap," is rarely reported with open procedures, and it can cause substantial life-threatening morbidity.^3,4 We report a case of gastropericardial fistula with acute respiratory distress syndrome complicating a PEHH 7 years after laparoscopy.

Clinical Summary

A 36-year-old man was admitted to our emergency department with clinical and radiologic findings of acute respiratory distress syndrome. He underwent a laparoscopic Nissen fundoplication for symptomatic refractory gastroesophageal reflux disease (GERD) 7 years previously: The diaphragmatic crura were not closed (hiatus normally narrowed), and 3 nonabsorbable sutures allowed a 4-cm–long fundoplication. Five years later, he had increasing pain in the left shoulder. The extensive assessment (computed tomography scan, magnetic resonance imaging, and arthroscopy) found no cause. . . . [Full Text of this Article]