Fig. 3

Intra-operatively, extensive lysis of adhesion was performed and the patient’s prior Nissen fundoplication was found to be partially undone. The blue arrow is pointing to the left limb of the wrapped stomach. After careful dissection, the left limb of the fundoplication was noted to be tethered around with a cord behind the esophagus resulting in significant esophageal torsion. Abbreviation: Eso = esophagus