Acute gastric dilatation: a life‐threatening early complication following laparoscopic hiatus hernia repair

2020 ◽  
Author(s):  
Melissa Wee ◽  
David S. Liu ◽  
Sarah K. Thompson
Keyword(s):  
Hernia Repair ◽  
Hiatus Hernia ◽  
Gastric Dilatation ◽  
Early Complication ◽  
Acute Gastric Dilatation ◽  
Life Threatening

680 ACUTE GASTRIC DILATATION: A LIFE-THREATENING EARLY COMPLICATION FOLLOWING LAPAROSCOPIC HIATUS HERNIA REPAIR

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Melissa Yun Wee ◽  
David S Liu ◽  
Sarah K Thompson
Keyword(s):  
Hernia Repair ◽  
Hiatus Hernia ◽  
Closed Loop ◽  
Gastric Fluid ◽  
Gastric Dilatation ◽  
Partial Fundoplication ◽  
Early Presentation ◽  
Acute Gastric Dilatation ◽  
Life Threatening ◽  
Nasogastric Decompression

Abstract   Laparoscopic anti-reflux surgery prevents reflux of gastric fluid into the oesophagus but it may also inhibit belching. Gastric outflow impairment may lead to a closed-loop obstruction and life-threatening acute gastric dilatation. Methods We report a case of a 69-year-old female who underwent a laparoscopic giant hiatus hernia repair and anterior 180° fundoplication. Post operatively, she suffered from gastroparesis that resulted in a closed-loop obstruction. This was managed successfully with nasogastric tube insertion and commencement of prokinetic agents. A review of the literature of acute gastric dilatation and hiatus hernia repair was made. Results In the last 30 years, there have been 7 cases of acute gastric dilatation following hiatus hernia repair. Timing was 7 months to 14 years following a 360 degree fundoplication. In most cases, the ensuing gastric dilatation led to venous congestion, tissue necrosis and perforation, necessitating emergency gastrectomy for control of sepsis. All patients required a prolonged hospital stay and one mortality was reported. Our case is unique, characterized by its early presentation, and occurring after a partial 180° fundoplication. Our patient was successfully managed non-operatively with nasogastric decompression and supportive measures. Conclusion Surgeons should be aware that acute gastric dilatation is a life-threatening complication which may occur following laparoscopic partial fundoplication. Early diagnosis and prompt nasogastric decompression are required to avoid gastric necrosis and significant morbidity.

scholarly journals Massive gastric dilatation leading to acute respiratory distress 1 year after a Nissen fundoplication

2018 ◽  
pp. bcr-2018-225927
Author(s):  
Fareeda Sohrabi ◽  
Francesco DiMaggio ◽  
Ala Alasadi ◽  
Dipankar Mukherjee
Keyword(s):  
Hernia Repair ◽  
Respiratory Distress ◽  
Surgical Intervention ◽  
Acute Abdominal Pain ◽  
Nissen Fundoplication ◽  
Incisional Hernia Repair ◽  
Gastric Dilatation ◽  
Day Case ◽  
Successful Management ◽  
Life Threatening

Acute massive gastric dilatation (AMGD) is a recognised complication after Nissen fundoplication.1 A 63-year-old man recently presented to our emergency department in acute respiratory distress, acute abdominal pain and distension, having had an elective umbilical port incisional hernia repair a day prior. In the year preceding his presentation, the patient had undergone a laparoscopic paraoesophageal hiatus hernia repair and excision of sac, posterior cruropexy, dual mesh reinforcement of repair and 360° fundoplication, as a day case. In between these two events, the patient was asymptomatic, and had a free diet with no further medical or surgical intervention. We hereby present successful management and discuss implications of this exceptional yet potentially life-threatening complication.

Life-threatening acute gastric dilatation with aorta compression in a 3-year-old child

2015 ◽  
Vol 57 (6) ◽  
pp. 1184-1186 ◽  
Author(s):  
Ah Young Kim ◽  
Se Yong Jung ◽  
Lucy Youngmin Eun
Keyword(s):  
Gastric Dilatation ◽  
Acute Gastric Dilatation ◽  
Life Threatening

scholarly journals Acute Gastric Dilatation in a 13 Year Old Child. A Case Report

2020 ◽  
Vol 18 (1) ◽  
pp. 52-53
Author(s):  
Elīna Kalnakārkle ◽  
Zane Ābola
Keyword(s):  
Acute Abdominal Pain ◽  
Clinical Signs ◽  
Abdominal Distension ◽  
Gastric Dilatation ◽  
Tube Insertion ◽  
Acute Gastric Dilatation ◽  
Life Threatening ◽  
Gastric Decompression ◽  
Nasogastric Tube Insertion

SummaryAcute gastric dilatation is a rare and life threatening disease. The usual symptoms of acute gastric dilatation can vary and be nonspecific, including acute abdominal pain, abdominal distension, nausea and vomiting. Many aetiologies of acute gastric dilatation are described. This article presents a case of a 13 year old girl who presented in our clinic with acute gastric dilatation after an orthopaedic operation. Clinical signs and a diagnostic pathway are presented in the report. In the early treatment of acute gastric dilatation, nasogastric tube insertion was used for gastric decompression. As a surgical approach jejunostomy insertion was used to ensure enteral feeding. Our case study shows that the optimal treatment for this pathology is mainly conservative.

scholarly journals Hepatic portal vein gas associated with intestinal ischemia and acute gastric dilatation

2020 ◽  
Author(s):  
YUN PAN
Keyword(s):  
Portal Vein ◽  
Intestinal Ischemia ◽  
Radiographic Finding ◽  
Gastric Dilatation ◽  
Short Period ◽  
Acute Gastric Dilatation ◽  
Life Threatening ◽  
Hepatic Portal Vein ◽  
Hepatic Portal ◽  
Highly Sensitive Detection

Abstract Background Hepatic portal vein gas is a rare and alarming radiographic finding for patients especially those who had intestinal ischemia. It often indicates a very serious infection and could result in infectious shock even death in a very short period of time, even though the mortality of hepatic portal vein gas went down with the increased use of computed tomography and ultrasound in the patient which allows early and highly sensitive detection of such severe illnesses. Case presentation Here a case was described in which the patient who had hepatic portal vein gas associated with intestinal ischemia and acute gastric dilatation died in a short time. Conclusions Attention must be paid closely to the patient who has hepatic portal vein gas associated with intestinal ischemia, and something must be done because it often indicates a life-threatening acute abdomen.

scholarly journals Acute Gastric Dilatation: A Cause for Concern

2021 ◽  
pp. 171-177
Author(s):  
Danial Haris Shaikh ◽  
Abhilasha Jyala ◽  
Shehriyar Mehershahi ◽  
Chandni Sinha ◽  
Sridhar Chilimuri
Keyword(s):  
Nasogastric Tube ◽  
Radiological Finding ◽  
Plain Film ◽  
Tube Placement ◽  
Gastric Dilatation ◽  
Acute Hyperglycemia ◽  
Acute Gastric Dilatation ◽  
Physician Awareness ◽  
Gastric Emphysema ◽  
Nasogastric Tube Placement

Acute gastric dilatation is the radiological finding of a massively enlarged stomach as seen on plain film X-ray or a computerized tomography scan of the abdomen. It is a rare entity with high mortality if not treated promptly and is often not reported due to a lack of physician awareness. It can occur due to both mechanical obstruction of the gastric outflow tract, or due to nonmechanical causes, such as eating disorders and gastroparesis. Acute hyperglycemia without diagnosed gastroparesis, such as in patients with diabetic ketoacidosis, may also predispose to acute gastric dilatation. Prompt placement of a nasogastric tube can help deter its serious complications of gastric emphysema, ischemia, and/or perforation. We present our experience of 2 patients who presented with severe hyperglycemia and were found to have acute gastric dilation on imaging. Only one of the patients was treated with nasogastric tube placement for decompression and eventually made a full recovery.

Spontaneous oesophageal perforation after laparoscopic hiatus hernia repair

2014 ◽  
Vol 85 (11) ◽  
pp. 887-888
Author(s):  
Martyn L. Humphreys ◽  
Bevan Jenkins ◽  
Jason Robertson ◽  
Michael Rodgers
Keyword(s):  
Hernia Repair ◽  
Hiatus Hernia ◽  
Oesophageal Perforation
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