To the Editor.—
The Angelchik prosthesis for treatment of gastroesophageal reflux and hiatal hernia was first described by Angelchik and Cohen1 in 1979. Since that time, it is estimated that more than 9,000 have been employed, with estimates of complications—primarily migration of the device and obstruction—ranging up to 10%.2 These devices have eroded into the stomach and migrated to other sites.2-5 A patient treated with an Angelchik prosthesis following failure of two previous antireflux procedures, in whom a gastrojejunal fistula and gastroesophageal fistulae from the device developed, is described herein.
Report of a Case.—
A 51-year-old woman with a long history of reflux esophagitis had undergone an Allison procedure without splenectomy and a Nissen fundoplication with splenectomy. In November 1982, the patient underwent endoscopy for recurrent symptoms, revealing reflux esophagitis and a fundoplication defect but no other gastric abnormality. Shortly after, an Angelchik prosthesis was placed. In
Ell SR. Gastrojejunal and Gastroesophageal Fistulae Following Placement of an Angelchik Prosthesis. JAMA. 1984;252(21):2961–2962. doi:10.1001/jama.1984.03350210017018
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