Gastrojejunal and gastroesophageal fistulae following placement of an Angelchik prosthesis

Abstract

<h3>To the Editor.—</h3> The Angelchik prosthesis for treatment of gastroesophageal reflux and hiatal hernia was first described by Angelchik and Cohen¹in 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%.²These devices have eroded into the stomach and migrated to other sites.^2-5A 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. <h3>Report of a Case.—</h3> 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