Esophagogastric fistula is an extremely rare complication of Nissen fundoplication surgery. Progressive dysphagia and odynophagia are the most frequent symptoms reported. Diagnosis is usually made two or three years after surgery, and although endoscopy is the gold standard to confirm diagnosis, radiologic barium swallow typically shows an image of a double column at the lower third of the esophagus and must be recognized as pathognomonic in patients with dysphagia after Nissen fundoplication. We report the first case completely resolved by laparoscopy and we recommend this approach in selected cases.
Granulocytic sarcoma is a rare neoplastic condition consisting of immature myeloid cells at an extra medullary site. We report a very infrequent case of ovarian granulocytic sarcoma in a patient with Philadelphia chromosome-positive acute biphenotypic leukemia who underwent emergency laparoscopic surgery (salpingo-oophorectomy), because an acute abdomen presentation. As far as we know, granulocytic sarcoma and biphenotypic leukemia (BAL) association have been described only four times in literature.
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