CT of Nissen's fundoplication.

The aim of this work is to describe the computed tomographic (CT) anatomy in patients who underwent Nissen's fundoplication. Forty patients (mean age = 61 years) with peptic esophagitis (nine cases), refractory gastroesophageal reflux (11 cases), and hiatal hernia (20 cases) were studied. Examinations were performed by third-generation CT equipment, with patients in the prone position after the ingestion of gastrovison and barium paste. In 34 patients, the examination demonstrated anatomical variations related to surgery, that is, the presence of a soft tissue mass at the level of the distal third of the esophagus. In four patients, a functional incompetence of the fundoplication (three cases) and a recurrent hiatal hernia (one case) were demonstrated. Our results suggest a possible application for CT study in postoperative follow up of patients who undergo Nissen's fundoplication, complementary to endoscopy and functional exams.