Port site tuberculosis and retained gall stone after laparoscopic cholecystectomy

Abstract

Laparoscopic cholecystectomy is one of the most common general surgical procedures performed. Port site infection is common surgical site infection. However, tuberculosis of port sites is very uncommon. We report a case of a 36-year-old lady who was presented to our center with complaint of swelling at midclavicular port and seropurulent discharge from epigastrium port site for one month after laparoscopic cholecystectomy done outside. Patient underwent wide local excision with stone retrieval and histopathology of specimen was suggestive of chronic inflammation. Following excision patient again develop swelling at scar site and FNAC from swelling reveal feature of tuberculosis, subsequently patient was started on anti-tubercular drug therapy and follow-up after 2 months show healthy suture line with no sinus or discharge or swelling.  Port site tuberculosis in absence of tuberculosis of gall bladder and abdominal is most likely due to contamination of instrument or dressing by mycobacterium tuberculosis. Diagnosis is made by ZN staining or FNAC or biopsy. Management includes incision and drainage or debridement or wide local excision with anti-tuberculosis medication. Following standardized sterilization procedure is essential for prevention.