Hello and welcome to HCM, The abdominal ultrasound reveals multiple lymph nodes in the abdomen. Multiple mesenteric lymph nodes can be found in may conditions like reactive conditions e.g. infection, tuberculosis, neoplasms- lymphoma etc. Mantoux test is done to rule out tuberculosis, however, the test is negative. A aspiration of the abdominal lymph nodes may be attempted. In aspiration, the cellular material is aspirated from the enlarged lymph nodes, spread on glass slides and stained with appropriate stains. The cells are examined under the microscope to look for nature and character of the lesion. Presence of fluid in the pouch of Douglas is seen after ovulation and also in some pathological conditions like pelvic inflammatory diseases. A clinical correlation is required to know the cause of fluid in POD. Thanks and take care Dr Shailja P Wahal