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What Do These Lab Reports For Discomfort At The Site Of C-section Surgery?

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Posted on Mon, 4 Jul 2016
Question: Hello mam

I had a c sec delivery in Nov 14.after three months of my discomfort and being on and off on different antibiotics an USG was conducted that revealed tuberculosis as a hypoechoivca track devloped fromproperitneal space upto skin.for which att was started from april 15.last month I finished the course of akt 4.but after 10,days gap swelling restarted.usg revelaed now subcutaneous edema in left infraumblial area..what could this be..is it again resurfacing of Tb..my dilemma is that whether it is Tb or cellulitis or cellulitis Tb..can u pls help.nt getting a proper cure.enclosing my reports
doctor
Answered by Dr. Manisha Jain (1 hour later)
Brief Answer:
Scar endometriosis

Detailed Answer:
Hello Mam, thanks for trusting me for discussion of your health issues.
I have seen the attached reports and according to history and description in reports, I'm suspecting scar site endometriosis.
Though a little deviated from typical history it still fits in as a diagnosis as you have already completed AKT4 but still there is resurgence.
In my opinion you should visit your gynecologist and discuss the option of starting leuprolide acetate injection for 6 months.
Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Manisha Jain (26 hours later)
Thanks mam for ur prompt reply

what could be the reasons and diffrential diagnosis for subcutaneous fat edema in abdomen (of usg mentioned area)

I would like to describe my history

After my delivery on 17 Nov 14,in a span of 1 week I developed redness and warmth on my area which had strech marks,which was very tender to touch at that time.i went to my gynae who operated and she refereed me to a dermatlogost..there was something wrong happened in my operation which was not being told to me.for near about 40 days I have had great amount of discomfort in sitting standing moving and while lying too.in the mean time I have had slight feverish feeling and bdominal discomfort .i changed doctors they gave e antibiotics but they used to be of minimal help..infection everytime resurfaced.was admitted in XXXXXXX and was given amikacin nd pipzo thru iv for three days..it relived me for two three days then again every symptom resurfaced ..then in Feb tht usg was conducted which said tb..again no doctr belived as everyone was in opinion tht these tracks are com.on post surgery..my treatment was delayed nd in April att was started..

Even then and now also tht radologist is very sure of this being a resurfacing of cellulitis and tuberculosis now in left side .as per his opinion the akt4 course was not sufficient as per my weights.

Again no one is beleiving as they are now saying its accumulated fat

I wil be very greatful if u can tell me that whether this has been a left untreated case of intial cellulitis tht created tb and now after leaving medicines it again is getting problematic


Does cellulitis in abdomen shows clinical picture like this..

Right now taking cefi xl d as prescribed by my gynae last year in same situation..is the course of taking it bd for 10 days fine.


Pls guide doc..my esr is 26 and crp is17.7 now

doctor
Answered by Dr. Manisha Jain (1 hour later)
Brief Answer:
Cesarean scar endometriosis

Detailed Answer:
I understand your plight.
It is uncommon but a very much known and a problematic thing.
As per your description it seems like endometriosis if the cesarean scar.
And I usually put my patients on dienogest tablet or Triptorelin depot injection depending on patient profile.
So discuss it with your gynecologist and then we can act accordingly.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Manisha Jain (1 hour later)
Thanks doc

But sry I didn't get detailed answer as per my query

Can i get scar endometriosis just after one week of my surgery and does that causes subcutaneous edema
Also if u can pls tell me that cefi xl d course is taken for 10 days bd as my gynae is out of country
doctor
Answered by Dr. Manisha Jain (3 hours later)
Brief Answer:
Diagnosis exclusion

Detailed Answer:
Yes complete your cefi XL course as per schedule and that might prevent secondary infections.
I told you earlier that definitely your presentation is not a typical one hug your history and investigations co-incite with the diagnosis of scar endometriosis.
Only other thing is tuberculosis but since that is not helping them scar endometriosis is the diagnosis as per the best of my knowledge and thus needs ample consideration.
In my opinion complete the course of AKT as advised and start dienogest which will show effect in 15-20 days time.
But since your gynecologist is out of city just complete Cefi XL course and Take pain killers and AKT as before.
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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Answered by
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Dr. Manisha Jain

OBGYN

Practicing since :2007

Answered : 5136 Questions

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What Do These Lab Reports For Discomfort At The Site Of C-section Surgery?

Brief Answer: Scar endometriosis Detailed Answer: Hello Mam, thanks for trusting me for discussion of your health issues. I have seen the attached reports and according to history and description in reports, I'm suspecting scar site endometriosis. Though a little deviated from typical history it still fits in as a diagnosis as you have already completed AKT4 but still there is resurgence. In my opinion you should visit your gynecologist and discuss the option of starting leuprolide acetate injection for 6 months. Take care