A Case of Intractable High Gastric Ulcer after Laparoscopic Nissen Fundoplication for Gastroesophageal Reflux Disease

Kazuto Tsuboi, Nobuo Omura, Fumiaki Yano and Hideyuki Kashiwagi^*

Department of Surgery, Jikei University School of Medicine
Department of Surgery, Jikei University School of Medicine, Kashiwa Hospital^*

A 59 year-old man with a worsening hiatal hernia and heart burn, was treated using laparoscopic Nissen fundoplication. During the operation, bleeding from the anterior trunk of the vagus nerve was observed, and hemostasis was performed using Laparoscopic Coagulation Shears. Six months after the operation, the patient experienced epigastralgia, and a gastric ulcer was found in the lesser curvature of the upper body during an endoscopy performed eight months after the operation. Laparoscopic Nissen fundoplication is a standard surgical treatment for GERD, and a tight Nissen or a slipped Nissen have been seen as general complications of this method. No reports of a gastric ulcer developing after a Nissen fundoplication procedure have been made in Japan, and only a few reports have been made in Europe and the United States. Thus, the present case is extremely rare and may be of interest to surgeons.

Key words
gastroesophageal reflux disease, laparoscopic Nissen fundoplication, gastric ulcer

Reprint requests
Kazuto Tsuboi Department of Surgery, Jikei University School of Medicine, Kashiwa Hospital 163-1 Kashiwashita, Kashiwa, 277-8567 JAPAN

Accepted
June 25, 2003

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