Laparoscopic procedures are routinely performed in most surgical centers today. Surgical site infections at port sites following laparoscopy are not uncommon. However, port site tuberculosis (TB) is a rare complication following a laparoscopic procedure. The possible causes of its development include improper sterilization of instruments, use of tap water containing resistant atypical mycobacteria to clean these instruments before immersion into glutaraldehyde solution; and seeding at the port site due to gall bladder TB. We report here a case of a young female who underwent laparoscopic cholecystectomy outside our hospital and then developed a discharging sinus at the epigastric port site. Three attempts of debridement and wound closure had already been done before and every time there was a recurrence. Sinus tract was excised after getting the sinogram, and the histopathology showed features consistent with TB. The patient was put on anti-tubercular therapy, and she had no recurrence after 3 months of follow-up.

We report a case of 14-year-old male, who presented to us with complaints of severe pain in abdomen, vomiting, and inability to pass feces and flatus. He was diagnosed as a case of peritonitis after careful history, examination, and investigations. The exact cause of peritonitis was not known. Exploratory laparotomy was done, and it was found that there was perforation of the right hepatic duct about 1 cm proximal to its confluence with the left hepatic duct. Perforation was closed around the T-tube. Postoperative T-tube cholangiogram was done after 3 weeks which confirmed the free passage of dye into the duodenum, and there was no leakage of dye. T-Tube was removed 4 weeks after the operation, and the patient was discharged in satisfactory condition. Postoperative follow-up was done for 3 months, and it was uneventful.

ObjectiveThe objective was to study megaloblastic anemia as a cause of pyrexia of unknown origin (PUO).Materials and MethodsWe conducted a study on 15 patients of megaloblastic anemia associated with fever, attending our hospital clinics over a period of 6 months.ResultsWhile 11 patients had symptoms suggesting foci of infection and responded well to intravenous antibiotics, 4 patients had neither any evidence of infection nor responded with empirical broad spectrum antibiotic treatment. They were treated with vitamin B12/folate therapy which led to marked improvement in fever within 48 h. Presenting complaints of the patients and severity/duration of fever along with other epidemiological data were also studied in each case.ConclusionThe present study led us to conclude that megaloblastic anemia forms an important and reversible cause of fever and should be ruled out in all patients presenting with PUO. This knowledge would help the physicians in adequate and timely management of these patients.

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