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

• Main Authors: Piotr K. Kowalewski, Robert Olszewski, Dariusz Michalik, Andrzej P. Kwiatkowski
• Format: Article
• Language: English
• Published: Termedia Publishing House 2017-04-01
• Series: Videosurgery and Other Miniinvasive Techniques
• Subjects: <i>bariatric surgery; infection; tuberculosis; case report; laparoscopic adjustable gastric banding; gastric band</i>
• Online Access: https://www.termedia.pl/Abdominal-tuberculosis-after-removal-of-an-adjustable-gastric-band-report-of-an-unusual-case,42,29811,1,1.html

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.