Fundoplication

Fundoplications are forms of antireflux surgery used as a second line of treatment of gastroesophageal reflux disease after failure of medical treatment and first line of treatment of paraesophageal hernia.

A gastric fold is wrapped around the distal esophagus which enforces the lower esophageal sphincter and prevent gastroesophageal reflux.

Types
  1. Nissen 360o posterior fundoplication.
  2. Toupet 270o posterior fundoplication.
  3. Dor 180-200o anterior fundoplication.
  4. Thal 270o anterior fundoplication.

Barium study of the upper GI is the main imaging technique for evaluation of postoperative fundoplication and its complications.

Fundoplication appears as a gastric fundal defect that surrounds the distal esophagus, locates below the diaphragm and no more than 2 cm in length. They should be proper esophageal emptying and no gastric reflux.

  • tight fundoplication: manifested as dysphagia and achalasia like symptoms and occurred when the fundoplication is tight and long (>2 cm)
  • slippage: the fundoplication surrounds the stomach with retraction of the gastroesophageal junction to the chest. it is manifested as recurrent gastroesophageal reflux
  • disruption: the most common complications and occurred when the fundal sutures slipped. it is manifested by recurrence of reflux symptoms
  • twisted fundoplication and gastric volvulus: rare and urgent complication
Share article

Article Information

rID: 35706
Section: Approach
Tags: refs, cases
Synonyms or Alternate Spellings:
  • Fundoplication types
  • Fundoplications

Support Radiopaedia and see fewer ads

Cases and Figures

  • Drag
    Case 1
    Drag here to reorder.
  • Drag
    Case 2
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.