Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0017168 (gastroesophageal reflux disease)
11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Numerous surgical procedures have been introduced to facilitate weight loss in morbidly obese individuals. Gastric reservoir reduction, wrapping the stomach with an inert fabric, is one such procedure. Nissen fundoplication has been performed in conjunction with this approach to prevent postoperative gastroesophageal reflux. Gastric perforation and functional gastroesophageal obstruction occurring as late as 71 months after this operation represent late complications. Perforation has developed in 14.6% of stomachs wrapped with polypropylene mesh. Nissen fundoplication may contribute to this complication.
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PMID:Late complications after gastric reservoir reduction with external wrap. 359 68

Nissen fundoplication is a safe and effective procedure for gastroesophageal reflux. Gastric ulceration leading to perforation is an uncommon late complication with a mechanism of action that is poorly understood. A 40-year-old male presented 3 years following his fundoplication with a perforated ulcer in the upper body of the stomach. The patient admitted ibuprofen use leading up to the perforation. The perforation was successfully repaired via laparoscopy, with good postoperative outcome. Gastric ulcer perforation post-fundoplication is a rare late outcome. Gastric perforation may have been precipitated by the use of non-steroidal anti-inflammatory drugs (NSAIDs) in concert with the vascular mechanical changes caused by this procedure. A review of the literature reveals only a handful of accounts of gastric ulcers or perforations as a late outcome. Of note, many of these perforations occur in the upper stomach and in tandem with NSAID use.
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PMID:Laparoscopic management of a late gastric perforation post-fundoplication. 3244 Mar 32