11 months following an elective paraoesophageal hernia repair, a female patient presents to the emergency department with severe dysphagia. A CT showed a distention of the distal oesophagus caused by a foreign body and dense material inside and outside the oesophagus wall. A gastroscopy confirmed the presence of a bezoar and secondary oesophagitis due to the intraoesophageal migration of Teflon pledgets. Even when used appropriately, only for the crus repair, the use of Teflon pledgets may result in fistulisation through the oesophagus. This complication suggests that the use of Teflon pledgets to buttress a hiatal hernia repair should be used with caution and that an alternative technique (eg, resorbable pledgets) could be preferred.
- gastro-oesophageal reflux
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Contributors EC suggested MR to write a case report about that patient. MR did a complete review of the literature with the following keywords: foreign bodies, pledget migration, hiatal hernia, erosion. After reading all the articles, MR and EC met to plan the writing of the case report. MR wrote the first draft of the article. The article was reviewed and edited by EC and MR. EC is the treating surgeon of the patient. She operated on the patient, assured her medical follow-up and had her consent to the case report. AP reviewed the article and suggested some modification to the writing and the structure. The images were chosen by EC. The case report was submitted by MR and EC. After having the reviewers' comments, the reviewed version was made by MR and revised by EC and AP.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Patient consent for publication Obtained.
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