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Congress: ECR25
Poster Number: C-12631
Type: Poster: EPOS Radiologist (educational)
DOI: 10.26044/ecr2025/C-12631
Authorblock: M. D. Ferreira, F. N. Botelho, I. S. Neto, G. Matos-Ferreira; Lisboa/PT
Disclosures:
Madalena Dias Ferreira: Nothing to disclose
Francisco Nobre Botelho: Nothing to disclose
Isabel Sousa Neto: Nothing to disclose
Guida Matos-Ferreira: Nothing to disclose
Keywords: Abdomen, Gastrointestinal tract, Stomach (incl. Oesophagus), Fluoroscopy, Diagnostic procedure, Surgery, Treatment effects, Hernia, Outcomes
Learning objectives To review the main types of fundoplication (Nissen, Toupet, Dor), a common surgical procedure for treating gastroesophageal reflux disease (GERD), and to identify key radiographic signs for assessing success or failure through fluoroscopic imaging.
Read more Background GERD results from gastric contents refluxing into the esophagus, causing symptoms such as heartburn, regurgitation, and dysphagia. The lower esophageal sphincter (LES) and crural diaphragm function as primary barriers to reflux. Contributing factors include transient LES relaxation, impaired motility, and increased intra-abdominal pressure. Chronic GERD can lead to complications such as esophagitis, Barrett’s esophagus, and esophageal adenocarcinoma. [1,2] Diagnosis is primarily clinical, supplemented by endoscopy, pH monitoring, and barium esophagography. While barium studies are useful for assessing hernias and motility disorders,...
Read more Findings and procedure details Preoperative ImagingKey radiographic findings in GERD patients undergoing evaluation include: Esophageal Peristalsis: Up to 50% of GERD patients exhibit nonspecific motility disorders, which may improve postoperatively. Identifying achalasia or scleroderma preoperatively is crucial, as fundoplication in these patients often results in poor outcomes. [6] Hiatal Hernia: Accurate identification of the gastroesophageal junction (GEJ) and diaphragmatic hiatus is essential. Large hernias may indicate a shortened esophagus, necessitating esophageal lengthening via Collis gastroplasty. [7] Shortened Esophagus: Suggested by a hiatal hernia that does not reduce...
Read more Conclusion Fluoroscopic imaging is essential for postoperative assessment of fundoplication, allowing dynamic evaluation of anatomical integrity, function, and complications. Early identification of abnormalities such as slipped, tight, or disrupted wraps enables timely intervention. Accurate radiological reporting and effective communication between radiologists and surgeons are critical for optimizing patient outcomes.
Read more References [1] LeBedis, C. A., Penn, D. R., Uyeda, J. W., Murakami, A. M., Soto, J. A., & Gupta, A. (2013). The diagnostic and therapeutic role of imaging in postoperative complications of esophageal surgery. Seminars in Ultrasound, CT and MRI, 34(4), 288–298. https://doi.org/10.1053/j.sult.2013.03.002[2] Manning, M. A., Shafa, S., Mehrotra, A. K., Grenier, R. E., & Levy, A. D. (2020). Role of multimodality imaging in gastroesophageal reflux disease and its complications, with clinical and pathologic correlation. Radiographics, 40(1), 44–71. https://doi.org/10.1148/rg.2020190029[3] Skueas, J.,...
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