Severe Referred Shoulder Pain Following Revision Fundoplication From a Stich on the Diaphragm

Am Surg. 2023 Nov;89(11):4866-4868. doi: 10.1177/00031348211011110. Epub 2021 Apr 13.

Abstract

Complications following fundoplication surgery for hiatal hernias are rare. Herein, we present the case of a 61-year-old woman who underwent a Nissen fundoplication, complicated by dysphagia, and a revision modified Toupet fundoplication for a hiatal hernia, after which she began to experience severe prandial referred left shoulder pain that was refractory to medical management. We hypothesized that a diaphragmatic suture placed during the revision fundoplication could be the source of the pain, and we elected to remove the suture, resulting in resolution of the pain. This pain remained resolved at the most recent follow-up on postoperative week six, and the patient had no further concerns.

Keywords: diaphragm; fundoplication; laparoscopy; phrenic; referred pain.

Publication types

  • Case Reports

MeSH terms

  • Diaphragm / surgery
  • Female
  • Fundoplication / adverse effects
  • Fundoplication / methods
  • Gastroesophageal Reflux* / complications
  • Gastroesophageal Reflux* / surgery
  • Hernia, Hiatal* / complications
  • Hernia, Hiatal* / surgery
  • Humans
  • Laparoscopy* / methods
  • Middle Aged
  • Shoulder Pain / complications
  • Shoulder Pain / surgery
  • Treatment Outcome