A Case of Spontaneous Rupture of the Stomach in an Adult 3 Years after Nissen's Fundoplication

Koji Doi, Nao Ogihara, Toshihiro Naganawa, Hideki Takada, Tatsuaki Nakashio, Eisaku Sato and Masaji Yamauchi

Departmant of Surgery, Tokai Central Hospital

A 60-year-old man undergoing Nissen's fundoplication 3 years earlier and admitted for abdominal pain and fullness was found in radiography to have severe stomach distension. He reported severe abdominal pain just after the first examination. The second examination showed free air, leading to a diagnosis of stomach rupture. Laparotomy showed digested food and flammable gas in the peritoneal cavity and a 5-cm longitudinal tear at the lesser curvature of the stomach, necessitating peritoneal drainage and total gastrectomy. Histological examination showed neither peptic ulcer nor cancer. We surmised that stagnant digested food fermented and generated gas swelling the stomach. The antireflex mechanism of fundoplication prevented gas from escaping, however, inducing the rupture.

Key words
Nissen's fundoplication, spontanous rupture of the stomach

Reprint requests
Koji Doi Department of Surgery, Tokai Central Hospital 4-6-2, Sohara-Higashijima-cho, Kakamigahara, 504-8601 JAPAN

Accepted
November 27, 2002

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