CONCLUSION AND RESULT:
Patient was prescribed long-term high-dose proton pump inhibitors (PPIs). He was advised to adhere to a soft diet regimen. His symptoms markedly improved 8 weeks following anti-secretory therapy and he was well-tolerating soft diet. A barium swallow was subsequently done which revealed normal passage of contrast material throughout the esophagus and stomach with no evidence of extravasation or leakage of contrast media (Figure 3). A repeat endoscopy demonstrated fusion of the fistulous tract with the distal esophageal lumen with no evidence of fistulous stoma upon endoscopic retroflexion in the gastric cardia (Figure 4). The Nissen fundoplication remained intact. Patient remained on PPIs and was switched to regular diet thereafter. Six months later, patient underwent a repeat barium esophagogram which was again normal and did not demonstrate any leakage of contrast media (Figure 5), corroborating a complete resolution of the EGF. Patient remained asymptomatic, performed well clinically and had good tolerance to regular diet.