Abdominal tuberculosis after removal of an adjustable gastric band – report of an unusual case

Piotr K. Kowalewski; Robert Olszewski; Dariusz Michalik; Andrzej P. Kwiatkowski

doi:10.5114/wiitm.2017.67137

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abstract:

Case report

Abdominal tuberculosis after removal of an adjustable gastric band – report of an unusual case

Piotr K. Kowalewski

,

Robert Olszewski

,

Dariusz Michalik

,

Andrzej P. Kwiatkowski

Videosurgery Miniinv 2017; 12 (2): 186–188

DOI: https://doi.org/10.5114/wiitm.2017.67137

Online publish date: 2017/04/11

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Laparoscopic adjustable gastric banding (LAGB) is the third most popular bariatric procedure. Despite its reversibility and minimal invasiveness, band infection affects 1.2% of patients. We present a case of a 25-year-old, obese woman who was experiencing malaise and feverishness 3 years after gastric band placement. Due to port site infection the port was removed, which did not improve the patient’s condition. After 2 years the band was removed via laparotomy with a minor surgical site infection reported. The patient returned 2 weeks after discharge with signs of sepsis. After ruling out pulmonary causes, an exploratory laparotomy was performed, revealing granulomatous peritonitis. Standard histopathological examinations, broncho-alveolar lavage culture and DNA tests along with microbiological cultures were inconclusive. Broad-spectrum antibiotics and antifungal and antiparasitic agents did not improve the patient’s condition. Mycobacterium tuberculosis DNA was discovered in a greater omentum specimen. The patient was treated with isoniazid, rifampicin, pyrazinamide and streptomycin for four months.

keywords:

Abdominal tuberculosis after removal of an adjustable gastric band – report of an unusual case

Piotr K. Kowalewski , Robert Olszewski , Dariusz Michalik , Andrzej P. Kwiatkowski

bariatric surgery, infection, tuberculosis, case report, laparoscopic adjustable gastric banding, gastric band

Piotr K. Kowalewski

,

Robert Olszewski

,

Dariusz Michalik

,

Andrzej P. Kwiatkowski