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What Does My USG Result Report Indicate?
Question: Hello sir.
I had a cesarean delivery in Nov 14.post op I devloped abdominal discomfort.in Feb 15 an USG was conducted that revealed an hypoechoic track from properitoneal space to skin in anterior abdoimanl wall.it doubted of Tb..bassed on positive igra mantoux nd USG att was started in april 15..took art for one year now till april 16..again swelling started ..may 16 USG now revealed subcutaneous edema..in infraumblical arae what could be the reasons for this..is it cellulitis panniculitis or reoccurence of tb..pls guide sir I m attaching my both USG as well as latest blood reports..are they pointed towards tissue necrosis again..pls help what should I do
I had a cesarean delivery in Nov 14.post op I devloped abdominal discomfort.in Feb 15 an USG was conducted that revealed an hypoechoic track from properitoneal space to skin in anterior abdoimanl wall.it doubted of Tb..bassed on positive igra mantoux nd USG att was started in april 15..took art for one year now till april 16..again swelling started ..may 16 USG now revealed subcutaneous edema..in infraumblical arae what could be the reasons for this..is it cellulitis panniculitis or reoccurence of tb..pls guide sir I m attaching my both USG as well as latest blood reports..are they pointed towards tissue necrosis again..pls help what should I do
Brief Answer:
Biopsy diagnosis is the final option.
Detailed Answer:
Hi, dear
I have gone through your question and your all reports. I can understand your concern.
Your ESR and CRP is slightly raised and your tuberculosis test is negative. So we can not conclude anything from your blood report.
Necrosis can be due to tuberculosis, cellulitis or some other cause.
Please tell me about your current symptoms.
Whether you have gone for ultrasound due to any symptoms or its just routine scheduled ultrasound.
If you don't have any symptoms of pain, redness, tenderness then cellulitis & panniculitis is less likely.
If you don't have any symptoms of weight loss and fever then chances of tuberculosis is also less likely.
It can be healed tuberculosis or some non specific oedema.
However there is some chances of drug resistant or recurrent tuberculosis.
The best thing is to go for biopsy diagnosis.
Tissue can be taken from that lesion and you will give exact diagnosis on histopathology whether is tuberculosis, panniculitis some other infective or inflammatory lesion or non specific cause.
Exact diagnosis is very important in your case because if it is drug resistant tuberculosis then 2nd line therapy is required. If it some other inflammatory disorder then steroids should be given.
Moreover from biopsy if it is tuberculosis or other infective lesion then culture and sensitivity can be done. So in my opinion biopsy should be done.
Before that please tell me about your symptoms.
You should also consult your gynaecologist once. Because it arise from complication of c section.
Hope I have answered your question. If you have doubts then feel free to ask me. I will be happy to answer.
Please give me follow up.
Thanks for using health care magic. Wish you a very good health.
Biopsy diagnosis is the final option.
Detailed Answer:
Hi, dear
I have gone through your question and your all reports. I can understand your concern.
Your ESR and CRP is slightly raised and your tuberculosis test is negative. So we can not conclude anything from your blood report.
Necrosis can be due to tuberculosis, cellulitis or some other cause.
Please tell me about your current symptoms.
Whether you have gone for ultrasound due to any symptoms or its just routine scheduled ultrasound.
If you don't have any symptoms of pain, redness, tenderness then cellulitis & panniculitis is less likely.
If you don't have any symptoms of weight loss and fever then chances of tuberculosis is also less likely.
It can be healed tuberculosis or some non specific oedema.
However there is some chances of drug resistant or recurrent tuberculosis.
The best thing is to go for biopsy diagnosis.
Tissue can be taken from that lesion and you will give exact diagnosis on histopathology whether is tuberculosis, panniculitis some other infective or inflammatory lesion or non specific cause.
Exact diagnosis is very important in your case because if it is drug resistant tuberculosis then 2nd line therapy is required. If it some other inflammatory disorder then steroids should be given.
Moreover from biopsy if it is tuberculosis or other infective lesion then culture and sensitivity can be done. So in my opinion biopsy should be done.
Before that please tell me about your symptoms.
You should also consult your gynaecologist once. Because it arise from complication of c section.
Hope I have answered your question. If you have doubts then feel free to ask me. I will be happy to answer.
Please give me follow up.
Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thanks sir
1...i left att inbapril 16..post that started swelling andbpain with feverish like feeling and chillsthen on 21 may usg was conducted .the radiologist was of feeling th4at it is devlopment of cellulitis again and reocc7rence of tb,then i went from physician to gynae but n8bdy agreed to that they say just lose ur weight..i m 71 kg )..
2..ibfeel discomfort and growing adhesions in my superficial area,sir can u pls tell me that does cellulitis presents picture like thisv..is thos a slow progression problem...
CANBTHIS UNTREATED CELLULITIS CAUSE ADHESIONS,...I DEVLOPED ITVIN JANB15 ALSO AFTR CESARAEN AND MRI IN FEB REVELAED SOME ADHESIONS TOO
3
an regarding biopsy ibwant to ask sir tht my radiologist strictky advised me to not go for any surgical intervention be it biopsy or laproscopy since he said it will create more sinusvtracks and fistula whichbwould be impossible tobheal..this has createdvfear in my mindbsir for ny furthe4 surgical intervention what can i do sir..pls guide
4..i have tenderness and pain in left area,,same like the one i used tobfeel last year wen this sinus trackbwas d2vloping
5
is there any advancevtest to rule out tb and cellulitis,,,does tb happens in sibcutaneous fat or this is fat necrosis...also y do i have borderline ldh..does that pointing towrds something serious...nobpdy is beliving that tb can happen in subcutaneous
6
in which disease these sinus tracks or tossue necrosis devlops...i have taken cours3 of akt 4 wasbthat sufficeint asvper my body weight(
7...i m scared that it will bloock my nerves and veins,.whose the best person to deal with thi
pls guidebinbdetails...inwill be greatful ssir..totallyvperplexed
1...i left att inbapril 16..post that started swelling andbpain with feverish like feeling and chillsthen on 21 may usg was conducted .the radiologist was of feeling th4at it is devlopment of cellulitis again and reocc7rence of tb,then i went from physician to gynae but n8bdy agreed to that they say just lose ur weight..i m 71 kg )..
2..ibfeel discomfort and growing adhesions in my superficial area,sir can u pls tell me that does cellulitis presents picture like thisv..is thos a slow progression problem...
CANBTHIS UNTREATED CELLULITIS CAUSE ADHESIONS,...I DEVLOPED ITVIN JANB15 ALSO AFTR CESARAEN AND MRI IN FEB REVELAED SOME ADHESIONS TOO
3
an regarding biopsy ibwant to ask sir tht my radiologist strictky advised me to not go for any surgical intervention be it biopsy or laproscopy since he said it will create more sinusvtracks and fistula whichbwould be impossible tobheal..this has createdvfear in my mindbsir for ny furthe4 surgical intervention what can i do sir..pls guide
4..i have tenderness and pain in left area,,same like the one i used tobfeel last year wen this sinus trackbwas d2vloping
5
is there any advancevtest to rule out tb and cellulitis,,,does tb happens in sibcutaneous fat or this is fat necrosis...also y do i have borderline ldh..does that pointing towrds something serious...nobpdy is beliving that tb can happen in subcutaneous
6
in which disease these sinus tracks or tossue necrosis devlops...i have taken cours3 of akt 4 wasbthat sufficeint asvper my body weight(
7...i m scared that it will bloock my nerves and veins,.whose the best person to deal with thi
pls guidebinbdetails...inwill be greatful ssir..totallyvperplexed
Brief Answer:
Please find detail answer below.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
1. You developed pain, fever and swelling just after a long course of ATT. So its difficult to say whether it is recurrence of TB or not.
2. Adhesion may be due to Post C section healing, Healing of tuberculosis or some other reason. Cellulitis is less likely.
3. I agree that there is risk of sinus or fistula development. But it is not impossible to treat. Your case is very complicated and for final diagnosis biopsy is needed. So in my opinion you can go for biopsy.
4. Your same symptoms just like before may be due to recurrence of TB but again it is just guessing work. We don't have evidence.
5. One thing is sure TB can develop in subcutaneous tissue. TB can develop anywhere in body except few avascular structure. Though chances are rare but it can.
Cellulitis can be diagnosed by symptoms but possibility is low.
There are many advanced test to detect TB. You can go for TB PCR but for that You need some material from that lesion for exact diagnosis.
We can not differentiate fat necrosis and Tuberculosis necrosis by radiology or imaging. You need biopsy for that.
6. Sinus tract & necrosis can be due to some non specific infection, stitch granuloma or infection, recurrence of tuberculosis or some other infective or inflammtory disease.
You ATT was ok but it may be drug resistant TB and in that case you need 2nd line treatment.
7. You need multiple team approach. So consult multi speciality hospital where infection specialist, TB chest physician, surgeon, radiologist, pathologist, plastic surgeon all can discuss and plan accordingly. Don't worry about blockage of vein its unlikely and not a big need of worry.
Hope I have answered your question. If you have any doubts then feel free to ask me any time. I will happy to answer you. Thanks for using health care magic. Wish you a very good health.
Please give me follow up. Because it is very difficult case and even I would like to know final diagnosis.
Please find detail answer below.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
1. You developed pain, fever and swelling just after a long course of ATT. So its difficult to say whether it is recurrence of TB or not.
2. Adhesion may be due to Post C section healing, Healing of tuberculosis or some other reason. Cellulitis is less likely.
3. I agree that there is risk of sinus or fistula development. But it is not impossible to treat. Your case is very complicated and for final diagnosis biopsy is needed. So in my opinion you can go for biopsy.
4. Your same symptoms just like before may be due to recurrence of TB but again it is just guessing work. We don't have evidence.
5. One thing is sure TB can develop in subcutaneous tissue. TB can develop anywhere in body except few avascular structure. Though chances are rare but it can.
Cellulitis can be diagnosed by symptoms but possibility is low.
There are many advanced test to detect TB. You can go for TB PCR but for that You need some material from that lesion for exact diagnosis.
We can not differentiate fat necrosis and Tuberculosis necrosis by radiology or imaging. You need biopsy for that.
6. Sinus tract & necrosis can be due to some non specific infection, stitch granuloma or infection, recurrence of tuberculosis or some other infective or inflammtory disease.
You ATT was ok but it may be drug resistant TB and in that case you need 2nd line treatment.
7. You need multiple team approach. So consult multi speciality hospital where infection specialist, TB chest physician, surgeon, radiologist, pathologist, plastic surgeon all can discuss and plan accordingly. Don't worry about blockage of vein its unlikely and not a big need of worry.
Hope I have answered your question. If you have any doubts then feel free to ask me any time. I will happy to answer you. Thanks for using health care magic. Wish you a very good health.
Please give me follow up. Because it is very difficult case and even I would like to know final diagnosis.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanku sir
Can u pls tell that what types of complication can arise if this is Tb in subcutaneous area and left untreated..
As I consulted a general surgeon today,he wasn't satisfied that indeed it was a case of Tb earlier asobecause as peer him there should have been a discharge or absecess..he thonks thos is some kind of left suture reaction that is causing this...but sir if it is this problem does that linger for such a long time..ita been one nd half year and I feel more fibrosis inside..he prescribed me ciplox and chymoral ane see if it works.is that fine
Can u suggest me some good doctor or trusted hospital for my problem..any references in XXXXXXX .i will be greatful...
Does these sinus tracks nd fibrosis happens in some other disease also..pls guide sir
Can u pls tell that what types of complication can arise if this is Tb in subcutaneous area and left untreated..
As I consulted a general surgeon today,he wasn't satisfied that indeed it was a case of Tb earlier asobecause as peer him there should have been a discharge or absecess..he thonks thos is some kind of left suture reaction that is causing this...but sir if it is this problem does that linger for such a long time..ita been one nd half year and I feel more fibrosis inside..he prescribed me ciplox and chymoral ane see if it works.is that fine
Can u suggest me some good doctor or trusted hospital for my problem..any references in XXXXXXX .i will be greatful...
Does these sinus tracks nd fibrosis happens in some other disease also..pls guide sir
Brief Answer:
You will develop other symptoms of tuberculosis.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
If it is tuberculosis then you will develop fever, weight loss, abscess and discharge.
It may be suture granuloma and it also leads to fibrosis.
Other causes are some infection or inflammation. It may be due to some suture peice, complications of surgery or healing.
So if you want to try his treatment then its ok. There is no problem in that.
As I said earlier you should consult multispeciality hospital. You can consult in XXXXXXX hospital in XXXXXXX
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic.
You will develop other symptoms of tuberculosis.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
If it is tuberculosis then you will develop fever, weight loss, abscess and discharge.
It may be suture granuloma and it also leads to fibrosis.
Other causes are some infection or inflammation. It may be due to some suture peice, complications of surgery or healing.
So if you want to try his treatment then its ok. There is no problem in that.
As I said earlier you should consult multispeciality hospital. You can consult in XXXXXXX hospital in XXXXXXX
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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