Question: Hello Doctor,

The patient is my younger sister. Details are as below.

Name : XXXXXXX
Age: 26 yrs
Gender : female

She is suffering from an unidentified sickness from past 1.5 year.
Her stomach area feels rigid , stiff , tight all the time. She doesnt feel healthy and hence becomes dull and feels low.
We tried all possible tests to identify the cause of the problem but none of the doctors could identify anythings.

List of tests tried.

1) Antibiotics for a few weeks thinking it was realted to digestion and stomach ache.
2) Ultrasounds
which showed some lymph nodes and were tested for being cancerous , the output of the test was negative.
2) Colonoscopy -> All clear
3) Hormone tests -> All normal
4) Blood tests such as CBC, IGA
5) Thyroid tests -> no problem noticed
6) CT scan of pelvis and chest which shows

Multiple small subcentimetric sesentric nodes noted.
Liver is normal in shape and size. No focal lesion seen IHBR are not dilated.
Gallbladder is normally distended and shows no radio opacity inside. CBD is not dilated.
SPleen and pancreas are normal in size,thickness and enhancement pattern.
Both kidneys and normal in location,shape,size and axis,Renal function are adequate
The adrenals are normal.
Urinary bladder is normal.
The stomach is normal in wall thickness. Rest of the gut loops up to the normal. The rectum is normal. Surrounding fat planes are maintained.
Aorta and illac vessels are normal.Other vessels are normal in course and diameter. There is no aneurysm or thrombosis.
No ascites is seen.
Uterus is normal.
Both ovaries shows multiple peripherally arranged follicles.
The spine is normal. No lysis is seen.
The plevic bones are normal.

She had a history of cysts 2 years back and she took homoepathy treatment for that and the cyst problem got solved hence it did not list in ultrasound
In CT scan however polyscistic cysts were cited and then we consulted a gynaecologist.
She suggested laproscopy.

8) Laproscopy
The gyane who did laproscopy was confident that my sister has Tuberculosis of Uterus, She noticed the fluid in pouch of XXXXXXX
Uterus was red with infection (she said)
She ordered a TB test to confirm the same from a special lab which came out negative.

She still was confident that my sister is suffering from TB of uterus and since then she started TB medicine course . It has been 3 months since
then but there is no improvement in the tightness and rigidity around the stomach area.



We are clueless what to do now . Please show us some way to identify the problem.

it started1.5 yrs back when she FELT TIGHTNESS IN RIGHT ABDOMEN had a constipation for few days and than there was little blood in stool.we went for a gastroentrentologist
note:-.tightnes and tenderness(right abdomen) was less in the biggening and then it spreaded and became huge
treatment given was as follows

A) Antibiotics for a few weeks thinking it was related to digestion and stomach ache.
B) Colonoscopy -> All clear
C) Ultrasounds...(REPORT ATESTED)
few lymph nodes seen in right inguinal region
it was than treated by the gynaec with the antibiotics but there was no relief than she adviced for F.N.A.C->REPORT ATTESTED
D) Hormone tests -> like fh, fsh, glucose(all nrml)
E) Blood tests such as CBC,ESR IGA
F) Thyroid tests -> no problem noticed
G) CT scan of pelvis and chest(REPORT ATTESTED):- MESENTRIC LYMPHADENOPATHY.POLYCYSTIC OVARIES
h) vitamin d3 ->14 counts(insuffceincy)treted with 3 dose in 15 days gaps via injectable vitamin D suppliments
note:-every thing was normal but ESR was always high 55 counts,2mnth later 60, 2 mnth later 58, after 52


She had a history of cysts 2 years back and she took homoepathy treatment for that and the cyst problem got solved hence it did not list in ultrasound
In CT scan however polyscistic cysts were cited and then we consulted the gynaecologist.
She suggested laproscopy.

I) Laproscopy:-REPORT ATTESTED
ࠠ The gyane who did laproscopy diagnosed Uterus was red with infection and told that there is a lot of inflammation in that region
DOC COLLECTED SAMPLE OF FLUID FROM (POD) AND TESTED IT FOR TB_PCR WHICH WAS FOUND NEGATIVE then She started treatment for (PID) WITH SOME HEAVY
ANTIBIOTIC INJECTIONS AND TABLETS BUT THERE WAS NO RELIEF AT ALL.THEN THE GYNEC SAID THAT I M
confident that SHE has Tuberculosis of Uterus,
ࠠ Uterus was red with infection (she said)
ࠠ She ordered a TB test to confirm the same from a special lab which came out negative.

ࠠ She still was confident that my sister is suffering from TB of uterus and since then she started TB medicine course . It has been 3 months since
ࠠ then but there is no improvement in the tightness and rigidity around the stomach area.

Hello Doctor,
Thanks for looking deeper into the problem. Here are the answers to the questions.


Is the pain or rigidity round the clock?
Yes Its constantly there day and night.

Is it related to food intake means it increases with meals or decreases after passing stools or flatus?

No , it is constant alwayz.
Does the severity wax and wane?
Although it is alwayz there but sometimes she just gives up and starts crying alot.
How does this discomfort disturb her day to day activities?
She was very jolly before and from past 1.5 yrs her dullness and silence has taken over. She looks irritated, talks less and least interested in anything.
Is she overweight?
Yes she is 5' 2" and her wght is 55-57 kg.
Does she maintains a normal posture or does she stoop forward?
Posture as such is normal , but she prefers lying down everytime( from past few months) .
Is she more sedentary than active?
She was very active and lively before , but now she is sedentary.
Does she exercise regularly?
No, She just feels weak and dull in doing any kind of activity.

Request you to please guide me what can we do to identify her problem .
Thanks a lot for your kind help.
XXXXXXX

Hello Doctor,

here are the replies to your questions Doctor
How is her appetite?

Apetite is ok , She eats enough but not very good as before.

Is there any history of psychological trauma preceding the illness?
Yes , my brother died a month before her illness started.

Was her B12 level done ?
CBC was done , not B12 as such ..

What is her academic and professional background?
She is MBA in HR

Regards
XXXXXXX


What is her academic and professional background?