Esophagogastric fistula in an adult following laparoscopic Nissen fundoplication: A case report of successful resolution of fistulization through conservative medical therapy

Abstract

Nissen fundoplication can engender different types of fistulae: gastro-bronchial, gastro-pericardial, trachea-esophageal and esophago-gastric. Esophago-gastric fistula (EGF) is an exceedingly rare entity following laparoscopic Nissen fundoplication. EGF is an epithelialized connection between the distal esophagus and gastric fundus, imparting a “double-lumen sign” to the esophagus lumen upon direct endoscopic visualization. To date, the primary mechanism for EGF development has not been fully elucidated given the rarity of the entity. Endosocopic or surgical modalities remain the gold standard for the treatment of EGF. We herein present a case of EGF in an older adult that was resolved by virtue of conservative medical treatment with proton pump inhibitors, sparing invasive approaches like endoscopy and surgery.