Patients with long-term chronic reflux exhibit esophageal mucosal mobilization and esophageal mucosa is further altered by sutured apposition between distal esophagus and gastric fundus, which is conducive to the formation of EGF [4]. Also, the vascular supply is jeopardized following Nissen fundoplication. Therefore, necrosis and ischemia along a suture line occur and thus fistulization ensues [4].