REOPERATIVE LAPAROSCOPIC HELLER MYOTOMY AND DOR FUNDOPLICATION IN A PATIENT WITH ADVANCED ACHALASIA, FULMINANT ESOPHAGEAL CANDIDIASIS, AND UNUSUAL INTRAOPERATIVE LEAK

Introduction: Patients with end-stage achalasia are poor surgical candidates. Method: The patient underwent reoperative laparoscopic Heller myotomy and Dor fundoplication, and a flash of esophageal fluid was suspicious for mucosal entrance. Upper endoscopy showed no leak. Results: The esophagram on POD #1 showed no evidence of a leak. She was discharged on POD #2 on a full liquid diet. At 3 months follow-up, she has gained 11 lbs. Conclusion: Reoperative laparoscopic Heller myotomy and Dor fundoplication can result in good outcomes in patients with advanced achalasia, Candidiasis, and malnutrition. Possible micro-abscesses in the esophageal wall can mimic esophageal leak.