Hi, Dr. Khaled, thanks at the platform of H. C. M. Form.
Since you are a doctor and you will understand many things very easily.
Pulmonary and Extra-pulmonary tuberculosis
are equally common in masses.
Testicular mass was there and you operated for that also.
Now pain is in right hypochondrium
and epigastrium region.
These both areas are different from each from each other but very close to each other and there is pleural effusion
on right side
You know that in pleural effusion patient feels pain & threshold of pain is different in different persons.
Aspiration of fluid from pleura will suggest the cause of disease, whether it contains pus or blood.
Send this aspirated fluid to lab for its culture both for bacteria and also for drug sensitivity.
Here following points are to be noted.
==== In the beginning it was in testicles for which you operated.
==== Pleaural effusion
==== Pain in liver i. e . might be an involvement of liver as cirrhosis of the liver are prone to tubercular peritonitis
. Alcoholic liver disease
are at an increased risk of tuberculosis ( sorry, but if you are chronic alcoholic please consider this point also). Involvement of liver is very common in both pulmonary and extra-pulmonary tuberculosis. Usually hepatic tuberculosis
is clinically silent.In liver tuberculosis we have keep vigilance over formation of granuloma because these granulomas coalesce to form a large tumour called as tuberculoma.
Tuberculomas which has undergone extensive caseating and liquefaction necrosis forms a tubercular abscess
,we can call it HEPATIC TUBERCULOSIS.
So dr. don't take unnecessary burden and take complete course of tuberculosis . This is my opinion and I hope you will recover very very soon .
Good luck. Dr. Het