Besides respiratory and gastrointestinal symptoms, SARS-CoV-2 also has potential neurotropic effects. Acute hemorrhagic necrotizing encephalopathy is a rare complication of Covid-19. This article presents a case of an 81-year-old female, fully vaccinated, who underwent laparoscopic transhiatal esophagectomy due to gastroesophageal junction cancer. In the early postoperative period, the patient developed persistent fever accompanied by acute quadriplegia, impaired consciousness, and no signs of respiratory distress. Imaging with Computed Tomography and Magnetic Resonance revealed multiple bilateral lesions both in gray and white matter, as well as pulmonary embolism. Covid-19 infection was added to the differential diagnosis three weeks later, after other possible causes were excluded. The molecular test obtained at that time for coronavirus was negative. However, the high clinical suspicion index led to Covid-19 antibody testing (IgG and IgΑ), which confirmed the diagnosis. The patient was treated with corticosteroids with noticeable clinical improvement. She was discharged to a rehabilitation center. Six months later, the patient was in good general condition, although a neurological deficit was still present. This case indicates the significance of a high clinical suspicion index, based on a combination of clinical manifestations and neuroimaging, and the confirmation of the diagnosis with molecular and antibody testing. Constant awareness of a possible Covid-19 infection among hospitalized patients is mandatory.

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choledocotomy was performed in 7 patients (25%). Primary or T-Tube choledocorraphy was performed in 5 (18%) and 2 patients (0,07%) respectively. The procedure was successful in 27 patients (96%). Due to hemodynamic instability, the procedure was finished prematurely in 1 patient leaving one stone and placing a T-Tube for further percutaneous clearance (0,05%). Major morbidity appeared in one patient consisting in biliary leakage and requiring reintervention (0,05%). Other major morbidity did not appear. 4 patients presented minor morbidity (14%). Median postoperative stay was 3 days. 11 patients were discharged before 24 hours (39%). No retained stones were documented. We used laser lithotripsy in 5 patients (18%). Conclusions: LCBDE is a safe and reproducible procedure, even in initial experience. Laser lithotripsy and a 3 mm choledoscope increase the global success rate allowing the trans-cystic approach in a considerable proportion of patients.

Gastrointestinal duplications can be found in all parts of the gastrointestinal tract. Duplications of the stomach comprise 2-8% of all duplications and are mostly diagnosed during the first year of life. We present a case of a gastric duplication cyst in a 29-year-old female, presenting with epigastric pain and vomiting. Preoperative diagnosis was assumed to be pyloric stenosis. Intraoperatively, a large mass that was attached to the greater curvature was found. Histopathology results were consistent with gastric duplication cyst.