腹腔镜食管裂孔疝修补术后并发食管胸膜腔瘘（EPF）临床罕见，早期诊断困难，病死率高。本文报道1例76岁女性患者行腹腔镜食管裂孔疝修补＋Nissen胃底折叠术后发生EPF的诊治过程，并结合文献分析其病因、诊断及治疗策略。本例提示，术后早期若出现高热、呼吸困难等症状，应高度警惕该并发症，及时行胸腔引流或口服造影剂CT检查以明确诊断。综合保守治疗（禁食、胃肠减压、胸腔引流、抗感染及营养支持）可为瘘口愈合创造条件，是有效的治疗手段。

Esophagopleural fistula (EPF) following laparoscopic hiatal hernia repair is a rare clinical complication, characterized by difficulty in early diagnosis and a high mortality rate. This article reports the diagnostic and therapeutic course of a 76-year-old female patient who developed EPF after undergoing laparoscopic hiatal hernia repair combined with Nissen fundoplication. The etiology, diagnosis, and management strategies are further analyzed in conjunction with the existing literature. This case suggests that early postoperative symptoms such as high fever and dyspnea should raise a high index of suspicion for this complication. Prompt diagnostic evaluation, including thoracic drainage or oral contrast-enhanced computed tomography, is essential for establishing the diagnosis. Comprehensive conservative management—including fasting, gastrointestinal decompression, thoracic drainage, anti-infective therapy, and nutritional support—can facilitate fistula healing and represents an effective treatment approach.