title: Paraesophageal hernia secondary to failed Nissen fundoplication mimicking lung abcess.
abstract: A 9 1/2-month-old girl was transferred to our institution for evaluation and treatment of a lung abscess. Presenting symptoms included low-grade fever, irritability, diarrhea, and tachypnea. Chest radiograph showed a dense opacity with an air-fluid level in the lower portion of the right hemithorax. When the radiograph was reviewed carefully, surgical clips from a previous Nissen fundoplication were visible within the area of consolidation. A barium study revealed evidence of a large paraesophageal hernia with an air fluid level, and no evidence of a lung abscess. The patient had a laparoscopic revision of the Nissen, which had slipped superiorly, and an esophageal hernia repair. Postoperatively, the patient did well and was discharged without any complications.
authors.affiliation: Department of Pediatric Pulmonology, Tulane University School of Medicine, USA.
authors.forename: Rupali
authors.initials: R
authors.lastname: Bansal
authors.forename: Cristina
authors.initials: C
authors.lastname: Zeretzke
authors.forename: Harold
authors.initials: H
authors.lastname: Neitzschman
authors.forename: Michael P
authors.initials: MP
authors.lastname: Kiernan
mesh_terms: D001466:Barium Sulfate; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging*; D018662:Fundoplication / Q000009:adverse effects*; D006551:Hernia, Hiatal / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008169:Lung Abscess / Q000175:diagnosis; D012086:Reoperation; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate