Pseudoachalasia occurring after laparoscopic Nissen fundoplication and crural mesh repair.
BACKGROUND
Benign esophageal pseudoachalasia is a rare condition.


CONCLUSIONS
We report the case of a 70-year-old man who complained of severe dysphagia after laparoscopic Nissen fundoplication and crural mesh repair performed for long-standing gastroesophageal reflux disease. Severe dysphagia and nocturnal aspiration developed soon after the operation. A marked dilatation of the esophageal body and a manometric pattern resembling achalasia was documented.


RESULTS
Endoscopic balloon dilatation was ineffective. Five months after the initial operation, the patient underwent revisional laparoscopic surgery that consisted of Nissen's wrap takedown, enlargement of the hiatus with partial resection of the mesh, Heller myotomy, and Dor fundoplication. After a 2-year follow-up, the patient is doing well and is free of symptoms.
Bonavina
Luigi
L
Department of Medical and Surgical Sciences, Surgical Unit, I.R.C.C.S. Policlinico San Donato, University of Milan School of Medicine, Milan, Italy. luigi.bonavina@unimi.it
Bona
Davide
D
Saino
Greta
G
Clemente
Claudio
C
D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology; D004931:Esophageal Achalasia / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D004943:Esophagogastric Junction / Q000473:pathology; D004945:Esophagoscopy; D005355:Fibrosis; D005549:Foreign-Body Reaction / Q000473:pathology; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000473:pathology / Q000601:surgery; D006551:Hernia, Hiatal / Q000473:pathology / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008365:Manometry; D009130:Muscle, Smooth / Q000473:pathology / Q000601:surgery; D009197:Myenteric Plexus / Q000473:pathology; D011183:Postoperative Complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D053120:Respiratory Aspiration / Q000209:etiology; D009418:S100 Proteins / Q000032:analysis; D013526:Surgical Mesh; D000267:Tissue Adhesions / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed
D009418:S100 Proteins