Failed Fundoplication and Complications of Antire Flux Surgery: Radiographic, Endoscopic and Laparoscopic Views

Background: Failed fundoplication and complications of antireflux surgery are challenging conditions. The ability for prompt diagnosis requires knowledge of the clinical, radiographic and endoscopic presentation. The primary care physicians, gastrointestinal radiologists and gastroenterologists play a crucial role in the management of patients with such a complex disease. Aims: To facilitate the diagnosis and treatment of patients with failed fundoplication and complications of antireflux surgery. Methods: First, we described the different types of laparoscopic fundoplications and presented their radiographic, endoscopic and laparoscopic features. Second, we described the different types and etiology of failed fundoplications and complications of antireflux surgery, depicted their radiographic, endoscopic and laparoscopic features, and discussed their treatment. The images presented in this article were collected from cases treated at the Esophageal Disease Center at Memorial Hermann Southeast Hospital in Houston, Texas. Results: From 09/02/2010 to 10/26/2015, a total of 50 reoperative antireflux surgeries were performed. The radiographic, endoscopic and laparoscopic features of different types of complications, prior to reoperative surgical intervention were depicted in 12 figures. Conclusion: The presentation of the radiographic, endoscopic and laparoscopic images depicted in this article provides a useful diagnostic reference that may facilitate diagnosis and treatment, and improve outcomes of patients with failed fundoplication and complications of antireflux surgery.