Intrathoracic herniation and perforation 18 years after open nissen fundoplication

Nissen fundoplication is the most commonly performed surgical procedure in the management of gastroesophageal reflux disease, Esophageal and gastric p erforations most commonly occur in the perioperative period and carry signi ficant morbidity, We describe a unique case of intrathoracic gastric wrap p erforation and its suspected pathophysiology almost two decades after the o riginal procedure.