Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Does This CECT Abdomen Report Indicate?
Question: My son who is 11 years age having weight 45 kg. physically fit plays well. is suffering from stomach ache since last 4-5 years . we have contacted several doctors but could not diagnose the problem. a 15 days back he felt ache in belly and felt unconcious for a minute we got him checked through CECT WHOLE ABDOMEN.
the report says -an elongated tubular blind ended structure measuring 5 mm in thickness is seen in right iliac fossa suggesting appendix. no inflammation is seen in surrounding fat planes enlarged lymphnodes are seen in the region.
multiple enlarged mesentric lymphnodes are seen largest measuring 12*11 mm in right illiac fossa.Liver is enlarged in size (14 cm). and shape shows homogenous attenuation .IHBR is not dilated . no space occupying lesion seen .portal veins and heptic veins are normal . rest all is normal such as gall blader/spleen/B/L kidneys/urinary bladder/rectum/B/L lung bases. kindly advice ....
the report says -an elongated tubular blind ended structure measuring 5 mm in thickness is seen in right iliac fossa suggesting appendix. no inflammation is seen in surrounding fat planes enlarged lymphnodes are seen in the region.
multiple enlarged mesentric lymphnodes are seen largest measuring 12*11 mm in right illiac fossa.Liver is enlarged in size (14 cm). and shape shows homogenous attenuation .IHBR is not dilated . no space occupying lesion seen .portal veins and heptic veins are normal . rest all is normal such as gall blader/spleen/B/L kidneys/urinary bladder/rectum/B/L lung bases. kindly advice ....
Brief Answer:
can be mesenteric adenitis, less commonly abdominal epilepsy
Detailed Answer:
Hello
Thanx for the query
CECT abdomen showing enlarged mesenteric nodes suggest that there may be mesenteric adenitis. In appendicitis there is inflammation of the appendix leading to increase in thickness,but 5 mm thickness is normal in pediatric age.Liver size of 14 cm is also normal for this age(upper limit is 15 cm according to one XXXXXXX study). CT scan rules out other anatomical abnormality which may cause abdominal pain.
You have said that he is suffering from pain for last 4-5 years.
I want to know the frequency,severity,location,any associated symptoms,aggravating or relieving factors. Is there any history of unconsciousness in past?
If after investigations and clinical examination nothing is suggestive then it may be functional pain abdomen which is a very common entity in pediatric age group.There is not any specific management for this entity and it is a benign condition which subsides on its own over a period of time.
Sometimes unconciousness associated with pain abdomen may be due to abdominal epilepsy but there must be similar history in past which I don't think there in case of your child.
His weight is 45 kg which suggests good growth. In any chronic disease growth is usually effected which is not in your case.
So, I would suggest you to continue the present medication as it will help in recovery from adenitis as seen in CECT.
No need to worry. It will be helpful for me further to reach any other diagnosis if you answer the questions I asked above.
I will be glad to answer if you have any query.
Regards
can be mesenteric adenitis, less commonly abdominal epilepsy
Detailed Answer:
Hello
Thanx for the query
CECT abdomen showing enlarged mesenteric nodes suggest that there may be mesenteric adenitis. In appendicitis there is inflammation of the appendix leading to increase in thickness,but 5 mm thickness is normal in pediatric age.Liver size of 14 cm is also normal for this age(upper limit is 15 cm according to one XXXXXXX study). CT scan rules out other anatomical abnormality which may cause abdominal pain.
You have said that he is suffering from pain for last 4-5 years.
I want to know the frequency,severity,location,any associated symptoms,aggravating or relieving factors. Is there any history of unconsciousness in past?
If after investigations and clinical examination nothing is suggestive then it may be functional pain abdomen which is a very common entity in pediatric age group.There is not any specific management for this entity and it is a benign condition which subsides on its own over a period of time.
Sometimes unconciousness associated with pain abdomen may be due to abdominal epilepsy but there must be similar history in past which I don't think there in case of your child.
His weight is 45 kg which suggests good growth. In any chronic disease growth is usually effected which is not in your case.
So, I would suggest you to continue the present medication as it will help in recovery from adenitis as seen in CECT.
No need to worry. It will be helpful for me further to reach any other diagnosis if you answer the questions I asked above.
I will be glad to answer if you have any query.
Regards
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
report of blood-RBC ARE NORMOCYCTIC
WBC ARE NORMAL
PLATELETS ARE ADEQUATE
NO ABNORMAL CELLS /HEMOPARASITE SEEN
AMYLASE SERUM-)spectrophotometry)-112 *******
no history of unconciousness in the past. only 15 days back early morning abdomen pain started felt vomitting and he fell on the floor.after a minute when he became normal he felt full pressure of urine.
WHENEVER HE FELT PAIN IT IS FOLLOWED BY VOMITTING AND HE IS ALLRIGHT.
earlier when he suffered from abdomen pain he was suggested some PACHANGUARD/GASRIPU SOME AYURVEDIC MEDICINES
We do not give him out side food /use RO water. now we have also minimised fats in his diet. kindly advice.
WBC ARE NORMAL
PLATELETS ARE ADEQUATE
NO ABNORMAL CELLS /HEMOPARASITE SEEN
AMYLASE SERUM-)spectrophotometry)-112 *******
no history of unconciousness in the past. only 15 days back early morning abdomen pain started felt vomitting and he fell on the floor.after a minute when he became normal he felt full pressure of urine.
WHENEVER HE FELT PAIN IT IS FOLLOWED BY VOMITTING AND HE IS ALLRIGHT.
earlier when he suffered from abdomen pain he was suggested some PACHANGUARD/GASRIPU SOME AYURVEDIC MEDICINES
We do not give him out side food /use RO water. now we have also minimised fats in his diet. kindly advice.
Brief Answer:
ABDOMINAL MIGRAINE LIKELY POSSIBILITY
Detailed Answer:
Hello Sir
Thanks for the query
It seems to be due to abdominal migraine, a condition more common in school going boys and different from usual migraine as unlike in adults abdominal pain not headache is a prominent feature. In this condition there is severe pain abdomen with vomiting without any other clinical and lab findings.
Some medications like propranolol or cyproheptadine have been found to prevent the attack. Nothing much to worry.
I would suggest you to consult a pediatrician/pediatric neurologist for further opinion.
Regards
ABDOMINAL MIGRAINE LIKELY POSSIBILITY
Detailed Answer:
Hello Sir
Thanks for the query
It seems to be due to abdominal migraine, a condition more common in school going boys and different from usual migraine as unlike in adults abdominal pain not headache is a prominent feature. In this condition there is severe pain abdomen with vomiting without any other clinical and lab findings.
Some medications like propranolol or cyproheptadine have been found to prevent the attack. Nothing much to worry.
I would suggest you to consult a pediatrician/pediatric neurologist for further opinion.
Regards
Above answer was peer-reviewed by :
Dr. Shanthi.E
pediatrician has suggested to consult surgeon.and he has prescribed medicines
tab Synoheal 3 days+tab zenflox 3 days +tab rablet 3 days + tab combiflam 1/2 tab in ase of pain.What is this treatment for......surgeon clearly refused for appendix but CT scan says : CT STUDYREVEALS SIGNIFICANT MESENTRIC LYMPHADENOPATHY AS PRESCRIBED . CLINICOPATHOLOGICAL CONFIRMATION IS SUGGESTED FOR APPENDICITIS. WHAT IS SPECIAL TEST TO BE DONE FOR APPENDIX. WHETHER THESE MEDICINES ADVISED BY SURGEON FOR CURING APPENDIX /OR TO ENLARGE THE APPENDIX SO THAT HE CAN OPERATE .....
PLEASE ADVISE
tab Synoheal 3 days+tab zenflox 3 days +tab rablet 3 days + tab combiflam 1/2 tab in ase of pain.What is this treatment for......surgeon clearly refused for appendix but CT scan says : CT STUDYREVEALS SIGNIFICANT MESENTRIC LYMPHADENOPATHY AS PRESCRIBED . CLINICOPATHOLOGICAL CONFIRMATION IS SUGGESTED FOR APPENDICITIS. WHAT IS SPECIAL TEST TO BE DONE FOR APPENDIX. WHETHER THESE MEDICINES ADVISED BY SURGEON FOR CURING APPENDIX /OR TO ENLARGE THE APPENDIX SO THAT HE CAN OPERATE .....
PLEASE ADVISE
Brief Answer:
Wait as this is not appendicitis
Detailed Answer:
Hello
First CT did not show thickened and enlarged appendix. Only on the basis of adenitis diagnosis of appendicitis could not be made.
Second there is a history of pain for 4-5 years, if this would be an appendicitis till now there must be some chronic changes(CT detects chronic changes if any) which is not here.The chance of chronic or recurrent appendicitis is less likely.
Third, there might be a possibility that this attack is different from previous one and there is fresh acute appendicitis. But acute appendicitis usually presents with fever and blood examination will show increase in neutrophil count with leukocytosis.This is also not in your case. Even adenitis finding is a very nonspecific cause of pain and it does not explain the previous episodes. Lymph nodes are not matted and growth of child is good so tubercular lymphadenitis is also very unlikely.
So I will go along with the surgeons not with the radiologist and will suggest you to continue the present treatment of adenitis and to consider for the diagnosis of abdominal migraine after consulting a physician.
I hope you are now satisfied with my answer.
If you have any further query, I will be glad to answer.
Thanking you
Regards
Wait as this is not appendicitis
Detailed Answer:
Hello
First CT did not show thickened and enlarged appendix. Only on the basis of adenitis diagnosis of appendicitis could not be made.
Second there is a history of pain for 4-5 years, if this would be an appendicitis till now there must be some chronic changes(CT detects chronic changes if any) which is not here.The chance of chronic or recurrent appendicitis is less likely.
Third, there might be a possibility that this attack is different from previous one and there is fresh acute appendicitis. But acute appendicitis usually presents with fever and blood examination will show increase in neutrophil count with leukocytosis.This is also not in your case. Even adenitis finding is a very nonspecific cause of pain and it does not explain the previous episodes. Lymph nodes are not matted and growth of child is good so tubercular lymphadenitis is also very unlikely.
So I will go along with the surgeons not with the radiologist and will suggest you to continue the present treatment of adenitis and to consider for the diagnosis of abdominal migraine after consulting a physician.
I hope you are now satisfied with my answer.
If you have any further query, I will be glad to answer.
Thanking you
Regards
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
