espanolLa cirugia antirreflujo mediante abordaje laparoscopico se considera el gold estandar para el tratamiento de la enfermedad por reflujo gastroesofagico y de la hernia de hiato. Los resultados postoperatorios presentan una morbimortalidad asociada baja y una buena satisfaccion en el medio largo plazo. Presentamos el caso clinico de un paciente de 53 anos intervenido de funduplicatura laparoscopica tipo Nissen-Rossetti que en el duodecimo dia postoperatorio presenta clinica de mediastinitis asociada a sepsis por perforacion intratoracica de la funduplicatura gastrica migrada a torax. El paciente es intervenido de forma urgente, realizandose drenaje toracico, laparotomia media supra-umbilical y cierre primaria de la perforacion. El postoperatorio se caracteriza por una estancia de 23 dias en la unidad de cuidados intensivos y por neumonia necrotizante, abscesos pulmonares y empiema pleural izquierdo. A 10 anos del episodio, el paciente se encuentra asintomatico y sin signos de recidiva clinica. Aunque la incidencia de las complicaciones tempranas en la cirugia antirreflujo es relativamente baja, es obligatorio sospechar de ellas en un paciente con sepsis por mediastinitis y cirugia reciente. Antes situaciones de extrema gravedad es necesario intervenir de forma urgente aunque la re-exploracion quirurgica del hiato es considerada una cirugia compleja y de elevado riesgo de iatrogenia. EnglishThe laparoscopic antireflux surgery is considered the gold standard for the treatment of gastroesophageal reflux disease and hiatal hernia. The postoperative results show a low associated morbidity and mortality and good satisfaction in the medium long term. We present the clinical case of a 53-year-old patient who underwent Nissen-Rossetti laparoscopic fundoplication who, on the twelfth postoperative day, presented with mediastinitis associated with sepsis due to intrathoracic perforation of the gastric fundoplication migrated to the chest. The patient was operated on urgently, performing thoracic drainage, supra-umbilical median laparotomy and primary closure of the perforation. The postoperative period is characterized by a 23-day stay in the intensive care unit and by necrotizing pneumonia, lung abscesses, and left pleural empyema. Ten years after the episode, the patient is asymptomatic and has no signs of clinical recurrence. Although the incidence of early complications in antireflux surgery is relatively low, it is mandatory to suspect them in a patient with sepsis due to mediastinitis and recent surgery. In front of extremely serious situations, it is necessary to intervene urgently, although the surgical re-exploration of the hiatus is considered a complex surgery with a high risk of iatrogenesis.