title: Curtain gastroplasty as an option in high risk emergency hiatus hernia repair.
abstract: BACKGROUND
  We describe a novel surgical technique used in the case of an 86-year-old Caucasian man with multiple comorbidities who presented with upper intestinal obstruction caused by a large paraoesophageal hiatus hernia and concurrent urinary sepsis.
  
  
  METHODS
  The technique,  which minimises both operative time and surgical trauma in this situation, uses the fundus of the stomach in a modified Dor anterior fundoplication as a gastric fundoplasty to close the defect. The total operative time was 70 minutes.
  
  
  RESULTS
  The patient's recovery was complicated by  a lower respiratory tract infection but he was discharged 14 days after surgery with a premorbid oral intake and activity level.
  
  
  CONCLUSIONS
  We believe this curtain gastroplasty technique represents another surgical option to reduce operative time and trauma in a subgroup of high risk  patients presenting with life threatening complications of a large hiatus hernia who have limited physiological reserve and evidence of current ongoing sepsis.
authors.affiliation: Wrightington, Wigan and Leigh NHS Foundation Trust, UK.
authors.forename: J S
authors.initials: JS
authors.lastname: Pollard
authors.forename: C J
authors.initials: CJ
authors.lastname: Lewis
mesh_terms: D000369:Aged, 80 and over; D004380:Duodenal Obstruction / Q000209:etiology / Q000601:surgery*; D004630:Emergencies; D004638:Emergency Treatment / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006551:Hernia, Hiatal / Q000150:complications / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D012141:Respiratory Tract Infections / Q000150:complications; D012307:Risk Factors