Paraoesophageal hernia with acute intrathoracic volvulus of the stomach after laparoscopic Nissen fundoplication

In experienced hands, the value of the laparoscopic Nissen fundoplication as antireflux correction is established. The case report concerns a woman who underwent an emergency laparotomy for acute intrathoracic stomach volvulus with incarceration, one year after a laparoscopic Nissen fundoplication was carried out without closure of the diaphragmatic hiatus. In literature acute postoperative paraoesophageal hernia with intrathoracic migration of the stomach as an early and late complication of the laparoscopic fundoplication has already been reported. The authors advocate the closure of the diaphragmatic crura as a routine manoeuvre during the laparoscopic fundoplication.