Complicated diaphragmatic hernia post laparoscopic Nissen fundoplication: a case report
Dublin Core
Title
Complicated diaphragmatic hernia post laparoscopic Nissen fundoplication: a case report
Subject
Gastric volvulus, Nissen fundoplication, GERD
Description
Abstract
Background The definition of gastroesophageal reflux disease is gastroesophageal reflux with associated symptoms
or complications. Because parents or guardians perceive the disease’s symptoms differently, it is difficult to determine
how common it is. Although gastric volvulus and wrap migration are well-known complications following Nissen
fundoplication, the herniation in our case was caused by a defect medial to the hiatus, which could potentially
compromise the patient’s life in the future.
Case presentation We present a rare complication post laparoscopic Nissen fundoplication, four years male
Egyptian child presented to emergency department by shock, rigid abdomen. X-ray and CT scan abdomen showed
herniated stomach with ischemic volvulus of the stomach and pneumoperitoneum, exploration was done and case
managed successfully.
Conclusion Gastric volvulus is a complication with high morbidity and mortality outcomes that could be missed
or misdiagnosed, especially post laparoscopic fundoplication, high index of suspicion is the key to detect such
complications. Defects in diaphragm could be present in pediatric patients because of congenital or acquired causes,
careful inspection of diaphragm during laparoscopic fundoplication is an important step to detect possible defects to
minimize post operative complications.
Keywords Gastric volvulus, Nissen fundoplication, GERD
Background The definition of gastroesophageal reflux disease is gastroesophageal reflux with associated symptoms
or complications. Because parents or guardians perceive the disease’s symptoms differently, it is difficult to determine
how common it is. Although gastric volvulus and wrap migration are well-known complications following Nissen
fundoplication, the herniation in our case was caused by a defect medial to the hiatus, which could potentially
compromise the patient’s life in the future.
Case presentation We present a rare complication post laparoscopic Nissen fundoplication, four years male
Egyptian child presented to emergency department by shock, rigid abdomen. X-ray and CT scan abdomen showed
herniated stomach with ischemic volvulus of the stomach and pneumoperitoneum, exploration was done and case
managed successfully.
Conclusion Gastric volvulus is a complication with high morbidity and mortality outcomes that could be missed
or misdiagnosed, especially post laparoscopic fundoplication, high index of suspicion is the key to detect such
complications. Defects in diaphragm could be present in pediatric patients because of congenital or acquired causes,
careful inspection of diaphragm during laparoscopic fundoplication is an important step to detect possible defects to
minimize post operative complications.
Keywords Gastric volvulus, Nissen fundoplication, GERD
Creator
Ahmed Maher1* , Ahmed Tayel1 and Karim Darwesh1
Source
https://doi.org/10.1186/s12245-025-01039-3
Date
2025
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Ahmed Maher1* , Ahmed Tayel1 and Karim Darwesh1, “Complicated diaphragmatic hernia post laparoscopic Nissen fundoplication: a case report,” Repository Horizon University Indonesia, accessed April 26, 2026, https://repository.horizon.ac.id/items/show/12875.