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KMID : 0816120060090010103
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Korean Journal of Pediatric Gastroenterolology and Nutrition
2006 Volume.9 No. 1 p.103 ~ p.107
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A Case of Belsey Mark IV Fundoplication after Failed Nissen Antireflux Surgery
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Shon Su-Min
Park Moon-Ho
Kim Ae-Suk
Hwang Jin-Bok
Shin Hyun-Jung
Keum Dong-Yoon
Park Chang-Kwon
Choi Won-Joung
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Abstract
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Antireflux surgery has been indicated in gastroesophageal reflux disease (GERD) that does not respond to medical treatments. Although the most commonly performed operation is Nissen fundoplication, Belsey Mark IV fundoplication is indicated for more complicated cases, such as, in cases of a failed Nissen operation or a long lasting hiatal hernia. Here, we report a case of Belsey Mark IV fundoplication for a failed Nissen fundoplication. The infant developed frequent times of aspiration pneumonia after initial Nissen for a hiatal hernia with GERD during the newborn period. At 15 months of age, a 2nd Nissen operation was attempted, but fundoplication was not available because of excessive mesenteric adherence to the liver and cardia. Therefore, Belsey Mark IV fundoplication was performed via trans-thoracic approach, which can provide full esophageal mobilization and better visualization of the herniated fundus and the surrounding tissues. Subsequently, she has shown an improved general condition without GERD.
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KEYWORD
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Nissen fundoplication, Belsey Mark IV fundoplication, Hiatal hernia, Gastroesophageal reflux disease
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