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What Causes Swelling And Pain In Abdomen 3 Months After C-section?
Question: I had ceserean delivey in nov 14, after that i have been expericing swelling and pain in abdomen, also the stretch marks of pregnency got red and radiates warmth, till i am on antibiotic, all things settle, but as soon i stop mediciens, they again become prominent, right i am taking zinase d, cefi xl 200, sumag ointment with hot fermentation.
I done an ultrasound, the radiologist says its possibility of tb in abdominal skin.
Please guide
I done an ultrasound, the radiologist says its possibility of tb in abdominal skin.
Please guide
Brief Answer:
Might be endometrosis , picture of leison required
Detailed Answer:
Hello mam, I understand your anxiety related to the issue.
It is very uncommon to have these symptoms after 3 months of c section.
In my opinion it can be either tuberculosis or endometriosis of the abdominal wall.
But both of these are difficult to assess.
Keep taking zynase D and apply sumag as before, no need of antibiotic now.
Also add low dose contraceptive pills or just progesterone pills after consulting your gynecologist.
Can you send me some pictures so that I can advise you better?
Waiting for your response.
Regards
Dr Manisha.
Might be endometrosis , picture of leison required
Detailed Answer:
Hello mam, I understand your anxiety related to the issue.
It is very uncommon to have these symptoms after 3 months of c section.
In my opinion it can be either tuberculosis or endometriosis of the abdominal wall.
But both of these are difficult to assess.
Keep taking zynase D and apply sumag as before, no need of antibiotic now.
Also add low dose contraceptive pills or just progesterone pills after consulting your gynecologist.
Can you send me some pictures so that I can advise you better?
Waiting for your response.
Regards
Dr Manisha.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
how is tb or endiometeriosis of abdominal wall identified?and if it is the case whose the doctor that wil deal with this issue a general surgeon ,physician or a gynae ,infectious diaease specialist i m taking zinase d for 12 days for howmany days can it be taken.will ct scan help me in identifying my problem.. can this be coverted into cancer if i will wait. whatbis the use of progestrone pills in my case.can this be cellulitis ..as per my radilogist it is cellulitis tuberculosis .pls guide
Brief Answer:
visit a surgeon
Detailed Answer:
In my opinion it is most likely tubercular cellulitis but still you need to visit a surgeon at the earliest and get a proper evaluation.
As it responded to iv antibiotic and now resurging again it is quite suggestive of tubercular cellulitis.
Endometriosis will not have responded at all and thus no effect of progesterone so no need to take progesterone.
CT scan will not help you as MRI and ultrasound are not suggestive of any abnormalities.
It is not going to change into cancer but definitely will deteriorate further so get it examined at the earliest.
Also keep applying moisturizer and avoid scratching as much as possible.
Cold sponging of the affected area will also offer you relief.
Zinase D can be taken for 3 weeks but take it with food or other meals always otherwise it can cause acidity.
You can discuss the management suggested by your surgeon on health care magic anytime.
All the best.
visit a surgeon
Detailed Answer:
In my opinion it is most likely tubercular cellulitis but still you need to visit a surgeon at the earliest and get a proper evaluation.
As it responded to iv antibiotic and now resurging again it is quite suggestive of tubercular cellulitis.
Endometriosis will not have responded at all and thus no effect of progesterone so no need to take progesterone.
CT scan will not help you as MRI and ultrasound are not suggestive of any abnormalities.
It is not going to change into cancer but definitely will deteriorate further so get it examined at the earliest.
Also keep applying moisturizer and avoid scratching as much as possible.
Cold sponging of the affected area will also offer you relief.
Zinase D can be taken for 3 weeks but take it with food or other meals always otherwise it can cause acidity.
You can discuss the management suggested by your surgeon on health care magic anytime.
All the best.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
what are the blood tests to confirm tubecular cellulitis.is it possible that this tubecular track have been dwvloped into me post iv treatment.since my first usg didnt reaveal anything..how is this treated do i need to go on ATT.I want to be sure of this before getting treatment of TB.PLS GUIDE
Brief Answer:
surgeon examination is must
Detailed Answer:
I know your anxiety about starting ATT but you have all symptoms which can be related only to tuberculosis and has no relation with IV track.
Ultrasound will not be able to give much information.
Resurgence of tuberculosis is very common after any major surgery.
For accurate documentation of tuberculosis your doctor might take skin biopsy for Tb -PCR but first get yourself examined.
Let's hope for the best.
surgeon examination is must
Detailed Answer:
I know your anxiety about starting ATT but you have all symptoms which can be related only to tuberculosis and has no relation with IV track.
Ultrasound will not be able to give much information.
Resurgence of tuberculosis is very common after any major surgery.
For accurate documentation of tuberculosis your doctor might take skin biopsy for Tb -PCR but first get yourself examined.
Let's hope for the best.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thanks doc.i went to my gynae today and she has now reffered me to physician.my physiacian is in the opinion of getting a ct scan of abdomen done and usg guided fnac.pls guide me of both in terms of safety and radiations involvement as per my health
for how long trial of att is given .my concern is that if i dont have that tb prob,i will still need to take so many med for at least 6 months,how to confirm whether i really reuired this as i have already been on so many amtibiotics for so long..will this att treatment will not make seroius side effects on my body.
i have got some blood work done tday.attaching all my reports.also i was on antibiotic for last 5 days,will these affect my blood work andESR.my chest x ray and tb gold test was negative too.
how is bacterial cellulitis identified.are there any test for thesame..its been three months of my surgery.will ct scan cause any harmful radiations that may hamper my healing futher.does it damage tissue.what does that hypoechoic track that is avasvular means..mri was repeated ii time already
IS There ny other test that i can get done to know about actual bactetial growth
PLS GUIDE
for how long trial of att is given .my concern is that if i dont have that tb prob,i will still need to take so many med for at least 6 months,how to confirm whether i really reuired this as i have already been on so many amtibiotics for so long..will this att treatment will not make seroius side effects on my body.
i have got some blood work done tday.attaching all my reports.also i was on antibiotic for last 5 days,will these affect my blood work andESR.my chest x ray and tb gold test was negative too.
how is bacterial cellulitis identified.are there any test for thesame..its been three months of my surgery.will ct scan cause any harmful radiations that may hamper my healing futher.does it damage tissue.what does that hypoechoic track that is avasvular means..mri was repeated ii time already
IS There ny other test that i can get done to know about actual bactetial growth
PLS GUIDE
Brief Answer:
see detailed description
Detailed Answer:
I can see the amount of anxiety you are suffering from and I know that you have been through enough so far.
But USG guided FNAC will be needed definitely to rule out any bacterial infection (if present) and at times it may give positive culture for tuberculosis which will give us an evidence in black and white that ATT is needed.
Even if culture is sterile then also ATT will be needed because tuberculosis is the only organism which can give such a vague clinical picture which is chronic and non responsive to the antibiotics.
ATT can cause minor symptoms like nausea and gastritis or can cause very severe problems in the form of jaundice and liver problems.
Bacterial cellulitis can only be documented by FNAC guided tissue retrieval followed by culture of the aspirate.
Avascular hypoechoic tract means there is a dead space which has no blood supply and thus heals with difficulty and is usually seen in chronic bacterial or tubercular infection.
Don't be afraid of the radiation hazard as all in all it is a very less amount of radiation and will not hamper any physiological normal being.
Get the test done and then we will discuss all the reports as a whole.
Wish you all the best
see detailed description
Detailed Answer:
I can see the amount of anxiety you are suffering from and I know that you have been through enough so far.
But USG guided FNAC will be needed definitely to rule out any bacterial infection (if present) and at times it may give positive culture for tuberculosis which will give us an evidence in black and white that ATT is needed.
Even if culture is sterile then also ATT will be needed because tuberculosis is the only organism which can give such a vague clinical picture which is chronic and non responsive to the antibiotics.
ATT can cause minor symptoms like nausea and gastritis or can cause very severe problems in the form of jaundice and liver problems.
Bacterial cellulitis can only be documented by FNAC guided tissue retrieval followed by culture of the aspirate.
Avascular hypoechoic tract means there is a dead space which has no blood supply and thus heals with difficulty and is usually seen in chronic bacterial or tubercular infection.
Don't be afraid of the radiation hazard as all in all it is a very less amount of radiation and will not hamper any physiological normal being.
Get the test done and then we will discuss all the reports as a whole.
Wish you all the best
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
mam pls detail me every minute detail about att..
Brief Answer:
see detailed description
Detailed Answer:
Hi,
Anti tubercular therapy is basically an intensive therapy with drugs which are specially designed for mycobacterium tuberculosis.
It is comprised of tablets Isoniazid, rifampicin, pyrizinamide and ethambutol and in severe cases streptomycin.
Most of the patients get only minor side effects of nausea and gastritis but some even get heavy symptoms like excessive nausea vomiting and even jaundice and severe malaise.
You will need regular liver function tests and also take acid eluting drugs like rabeprazole or ranitidine on regular basis.
Regular follow up with your doctor is very important.
I hope all this information will help you and give you enough of boost.
All the best.
see detailed description
Detailed Answer:
Hi,
Anti tubercular therapy is basically an intensive therapy with drugs which are specially designed for mycobacterium tuberculosis.
It is comprised of tablets Isoniazid, rifampicin, pyrizinamide and ethambutol and in severe cases streptomycin.
Most of the patients get only minor side effects of nausea and gastritis but some even get heavy symptoms like excessive nausea vomiting and even jaundice and severe malaise.
You will need regular liver function tests and also take acid eluting drugs like rabeprazole or ranitidine on regular basis.
Regular follow up with your doctor is very important.
I hope all this information will help you and give you enough of boost.
All the best.
Above answer was peer-reviewed by :
Dr. Raju A.T
Hi mam.
Thanks for the detailed reply.
I consulted a general surgeon and a infectious disease specialist yesterday
In surgeon opinion after seeing my mri nd ultrasound reports has prescribed me again some medications.
Flucort ointment chymoral forte tds tayo 60k once weekly and tab nurokind and folic acid with one test oc cect abdomen and barium meal through follow
As per infectious disease specialist he suggested for fnac and montoux test to start att or not
Now keeping in view of my health condition and allergic problem is montox test and ce ct safe for me as i m already in healing phase and last year before pregnany i also got cect done..aftr getting that done i had allergy and severe shivering for a day.is it safe in teems of radiation during my healing process
Is ct plain helpful in detection of bowel obstruction or tb..or should i go for 3rd mri
How is fnac done and what are the chances of side effects of this procedure
Can an allergic asthmatic can get mantoux done ,
And what if all these test came negative and still i need to go for empirical att.my gynae said that they follow an empirical att approach to women of i fertility too.is that true mam . I dnt want go fora laproscopy as i m scared ofany further surgeries and their complications post op becaz of these xonsequences
And despitetakingso many medicinesas llist attached ,should i gollow a surgeon prescribed medicine for a week and see if that works,becaz wen i was on zinase d last 15 daysback my track was reduced from 27mm to 14 mm.,had it been tubecular shuld it have been reduced like this
Should i really go for empirical att directlyfor a trial of 2 to 4 weeks..will it be safe for long period of lifetime.in terms of its resitance and reoccurence
I was given amikacin pipzo and orni wen i was admitted .are these also drugs of tb.i read it on net and found them as a second line of treatment.why i was not given ist line
.Pls guide in a detailed manner
Thanks for the detailed reply.
I consulted a general surgeon and a infectious disease specialist yesterday
In surgeon opinion after seeing my mri nd ultrasound reports has prescribed me again some medications.
Flucort ointment chymoral forte tds tayo 60k once weekly and tab nurokind and folic acid with one test oc cect abdomen and barium meal through follow
As per infectious disease specialist he suggested for fnac and montoux test to start att or not
Now keeping in view of my health condition and allergic problem is montox test and ce ct safe for me as i m already in healing phase and last year before pregnany i also got cect done..aftr getting that done i had allergy and severe shivering for a day.is it safe in teems of radiation during my healing process
Is ct plain helpful in detection of bowel obstruction or tb..or should i go for 3rd mri
How is fnac done and what are the chances of side effects of this procedure
Can an allergic asthmatic can get mantoux done ,
And what if all these test came negative and still i need to go for empirical att.my gynae said that they follow an empirical att approach to women of i fertility too.is that true mam . I dnt want go fora laproscopy as i m scared ofany further surgeries and their complications post op becaz of these xonsequences
And despitetakingso many medicinesas llist attached ,should i gollow a surgeon prescribed medicine for a week and see if that works,becaz wen i was on zinase d last 15 daysback my track was reduced from 27mm to 14 mm.,had it been tubecular shuld it have been reduced like this
Should i really go for empirical att directlyfor a trial of 2 to 4 weeks..will it be safe for long period of lifetime.in terms of its resitance and reoccurence
I was given amikacin pipzo and orni wen i was admitted .are these also drugs of tb.i read it on net and found them as a second line of treatment.why i was not given ist line
.Pls guide in a detailed manner
Brief Answer:
FNAC must
Detailed Answer:
Hello mam, I have seen the reports and medication and considering everything in total I want you to opt for FNAC followed by ATT (even if FNAC is negative for tuberculosis)
There is no need for CECT or MRI and thus no need to suffer because of radiation effects in your body.
No need to get mantoux test as firstly your have allergic tendency and moreover even if mantoux is non reactive which is there many a times in case of cutaneous tuberculosis and also in post natal period.
Your gynecologist is very right in asking you to take empirical ATT, I'm also in that favour.
Amikacin and piperacilillin are basically higher level of antibiotics and thus are even effective in tuberculosis to some extent and that is the reason you showed positive response to the antibiotics (though problem resurged).
These antibiotics were not given keeping tuberculosis in their diagnosis at that time.
Just get the FNAC done and then we can discuss further management.
Take care
FNAC must
Detailed Answer:
Hello mam, I have seen the reports and medication and considering everything in total I want you to opt for FNAC followed by ATT (even if FNAC is negative for tuberculosis)
There is no need for CECT or MRI and thus no need to suffer because of radiation effects in your body.
No need to get mantoux test as firstly your have allergic tendency and moreover even if mantoux is non reactive which is there many a times in case of cutaneous tuberculosis and also in post natal period.
Your gynecologist is very right in asking you to take empirical ATT, I'm also in that favour.
Amikacin and piperacilillin are basically higher level of antibiotics and thus are even effective in tuberculosis to some extent and that is the reason you showed positive response to the antibiotics (though problem resurged).
These antibiotics were not given keeping tuberculosis in their diagnosis at that time.
Just get the FNAC done and then we can discuss further management.
Take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thanks doc.pls detail me every possible detail regarding att,..its future outcomes and side effects on body ..nd future resistance on any disease after att is completed.is it really that simple to take att, and if in future sme disease or health condition occurs ,do medications remain effective like normal antibiotics for viral fever likewise...pls provide me all relwvant info..is itbpossible to have low esr and have tb.
does tb treatment is also given to infertility patients
my crp is coming 7..what doesthat indicate
one of my doc has given ayurveda treatment with this can i continue
somewhere i m not in favour of getting fnac done because even if that comes negative i wil still have to follow empirical att.moreover my physician said that if it will be tubecular the fnac wound will not heal easily..,my sugar fasting is voming as 106
pls guide
does tb treatment is also given to infertility patients
my crp is coming 7..what doesthat indicate
one of my doc has given ayurveda treatment with this can i continue
somewhere i m not in favour of getting fnac done because even if that comes negative i wil still have to follow empirical att.moreover my physician said that if it will be tubecular the fnac wound will not heal easily..,my sugar fasting is voming as 106
pls guide
Brief Answer:
take ATT as advised
Detailed Answer:
Hello mam, yes ATY is just like simple antibiotics and it has no effect on antibiotic efficacy in future and has no implications on future resistance to disease and drugs.
It is a little difficult to tolerate the therapy and most important thing is compliance.
You should not forget or leave the drugs in between otherwise they can cause resistance.
For side effects I have already told you in our previous discussion that it has no major long term effects so don't be anxious about it.
Yes ESR is a very non specific investigation so that cannot be the deciding parameter.
You can take Ayurveda medicine if you want along with ATT.
Sugar levels are normal.
FNAC can be postponed to see the effect of ATT.
All the best
take ATT as advised
Detailed Answer:
Hello mam, yes ATY is just like simple antibiotics and it has no effect on antibiotic efficacy in future and has no implications on future resistance to disease and drugs.
It is a little difficult to tolerate the therapy and most important thing is compliance.
You should not forget or leave the drugs in between otherwise they can cause resistance.
For side effects I have already told you in our previous discussion that it has no major long term effects so don't be anxious about it.
Yes ESR is a very non specific investigation so that cannot be the deciding parameter.
You can take Ayurveda medicine if you want along with ATT.
Sugar levels are normal.
FNAC can be postponed to see the effect of ATT.
All the best
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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