Clin Endosc.  2014 Jan;47(1):104-107.

A Case of Postfundoplication Dysphagia without Symptomatic Improvement after Endoscopic Dilatation

• Kyung C
• Jeon HH
• Kim H
• Kim JH
• Youn YH
• Park H

Abstract

Laparoscopic fundoplication is a treatment option for gastroesophageal reflux disease refractory to medical treatment. When deciding whether or not to undergo surgery, patients with refractory gastroesophageal reflux disease and esophageal motility disorder need to fully understand the operative procedure, postoperative complications, and residual symptoms such as dysphagia, globus sensation, and recurrence of reflux. Herein, we report a case of a patient diagnosed with gastroesophageal reflux disease and aperistalsis who underwent Nissen (total, 360degrees) fundoplication after lack of response to medical treatment and subsequently underwent pneumatic dilatation due to unrelieved postoperative dysphagia and globus sensation.

Keyword

Fundoplication; Deglutition disorders; Gastroesophageal reflux; Pneumatic dilatation

MeSH Terms

Deglutition Disorders*
Dilatation*
Esophageal Motility Disorders
Fundoplication
Gastroesophageal Reflux
Humans
Postoperative Complications
Recurrence
Sensation
Surgical Procedures, Operative

Figure

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  Fig. 1 Preoperative manometry showing normal lower esophageal sphincter relaxation during swallowing, and no peristalsis was seen in the esophageal body.

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  Fig. 2 (A) Postoperative esophagogastroduodenoscopic images showing postfundoplication status. (B) The endoscope could pass through the gastroesophageal junction without any resistance.

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  Fig. 3 Esophagography. Abnormal barium stasis in the esophageal body was observed (A, postoperation). Barium passage through the esophagus was improved (B, after pneumatic dilatation).

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  Fig. 4 Postoperative abdominopelvic computed tomographic image showed paraesophageal hernia.

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  Fig. 5 Postoperative high resolution manometry. Aperistalsis was observed in the esophageal body.

Reference

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