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Unusual cause of new onset persistent dysphagia after Nissen fundoplication

B Dallemagne, MD J Marescaux, MD, FACS, Hon FRCS, Hon FJSES, Hon FASA, Hon APSA
Epublication WebSurg.com, Jul 2009;09(07). URL: http://websurg.com/doi/vd01en2662

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  • 2009-07-16
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Persistent troublesome dysphagia develops in a small percentage of patients after Nissen fundoplication. Mild transient solid food dysphagia is an unavoidable side-effect of the operation. However, severe persistent dysphagia is probably related to poor patient selection, inadequate preoperative evaluation or technical errors, in most cases, excessively tight or long fundoplication. If dysphagia persists after dilatation, an outflow obstruction different to too tight or too long a wrap should be suspected as in this case. Re-operation may be needed if evidence of a poorly constructed wrap is apparent during the evaluation.