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    What do these lab reports indicate?

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Posted on Fri, 7 Jul 2017 in X-ray, Lab tests and Scans
Question: what is meant by altered echogencity of subcutaneous fat in Abdomen.. Pls explain in detail.. what are the possible causes for that???
doctor
Answered by Dr. Prof. Kunal Saha 1 hour later
Brief Answer:
Could be due to central obesity

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through your query and understand your concerns. However, I would insist you to upload the entire ultrasound report in order to help me correlate. As such it could simply be referring to abdominal fat due to central obsesity (fat is echogenic). It could also point to lipoma but in absence of a swelling I doubt if that is the case.

I would await your response. Let me know if I could help further.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prof. Kunal Saha 41 hours later
Hi, I have provided some attachments. Please review them.


In my blood work crp is 16.5 else normal... What is this pointing about
doctor
Answered by Dr. Prof. Kunal Saha 1 hour later
Brief Answer:
Indicates an inflammation of fatty tissues

Detailed Answer:
Thanks for writing back. I have gone through the report. It indicates a presence of inflammation of subcutaneous adipose tissue (the fatty layer under the skin) technically known as panniculitis. The elevation of CRP also indicates toward the inflammation. The cause of this inflammation however needs explanation and that would call for clinical correlation.

Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Prof. Kunal Saha 3 hours later
thanks sir

what could be possible cause of this.. I have history of lscs
after which a sinus tract in right anterior abdominal wall was devloped..

what can be done is this Tb or auto immune disorder...

what is the treatment for this

is surgery safe in both or any of these problems
doctor
Answered by Dr. Prof. Kunal Saha 45 minutes later
Brief Answer:
The diagnosis of the underlying cause is important

Detailed Answer:
Thanks for writing back. Although LUCS might not be directly related, the formation of the sinus tract could be linked and could have contributed to the panniculitis. It needs to be ascertain whether there are other evidence pointing to tuberculosis or autoimmune diseases. Treatment would depend upon the underlying cause which needs to be identified. Most often treatment of the underlying problem resolves this complaint. I do not think you need to panic. Let the diagnosis be done first. Pain relief can be done using anti-inflammatory medications such as aspirin, ibuprofen or diclofenac. Systemic steroids (oral or injected) might help to settle the inflammation. Anti-inflammatory antibiotics including tetracycline or hydroxychloroquine might be given. Surgical removal might be needed only in persistent or ulcerated lesions. Surgery has its own risks but I do not think that to be the first thing that you need to worry about.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prof. Kunal Saha 2 days later
Thanks sir

What is the ideal way for diagnoses of this diseases.. Is biopsy the option and is it safe in any of this disease?? I m not panic but taking att for last two and half years so now tired also my doc started hcqs 200 with that for last three months and I came to know that this Med has some serious side effects..still the problem has increased from right to left side... Also enclosed is reviewd mri report.. Pls gyide
doctor
Answered by Dr. Prof. Kunal Saha 6 hours later
Brief Answer:
Please provide details of your complaints

Detailed Answer:
Thanks for writing back. Prior to answering your question I would need to ask you the exact complaints that you had, how and when it started, its progression and any other relevant details. I have checked the MRI and it does not show anything in particular. The treatment with HCQS is on the right lines. Unfortunately these medicines do have a lot of side effects.

I would await your response.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prof. Kunal Saha 3 days later
Thanks doc
It all started after lscs.. In Nov 14 ..withinn Feb 15 a sinus tract was developed from properitoneal space up-to skin. Though it never had discharge.. For which one year att was given April 15 to April 16

But again in May I had same problem USg reveled again intralobular edema in anterior abdominal wall. Again att started that I m still taking sep till now macox plus and levomac 500

In Oct USg again revelead fat necrosis and then hcqs was started along with att

But I left it in March hcqs) since I wasn't able to tolerate and I felt my prob was increasing... Currently I have stiffness in abdominal fat.. With sitting n standing discomfort which is now further increase ing...i have allergic bronchitic also... is it possible it is suture reaction or tb or auto immune disorder
doctor
Answered by Dr. Prof. Kunal Saha 59 minutes later
Brief Answer:
The LSCS factor needs to be taken in consideration.

Detailed Answer:
Thanks for writing back and for detailing the facts. I would insist you to get a second opinion. The treatment line was otherwise proper but I would like to take into consideration that during a surgery there are a lot of bleeders (blood vessels that get cut and bleed) that need to be sealed. This could compromise the blood flow to certain (fatty) regions and could lead to fat necrosis. Since those blood vessels are not going to open up, the problem remains. HCQS or anti-tubercular treatment would not resolve the problem. As such I do not think suture reaction is involved but autoimmune cause could indeed be associated. I find tuberculosis to be less likely and unless tests point to tuberculosis, I would not otherwise consider it.

Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Prof. Kunal Saha 5 hours later
thank u sir
1...can u plz let me know whom second opinion should be considered (surgeon gynae physician or rhuematologist

2 what is the actual solution and proper way of solving this problem.. Pls guide sir what should I do

3..should I go for a repeated surgery and even if it is so is it safe in if Tb) or auto immune problem.. will they be able to clear up those I'll defined areas of focal fat necrosis.
.does diagnostic lap helpful or open surgery

4is this possible that I m given treatment for Tb but in actual this fat necrosis is cancerous.. is fat necrosis a common finding

5i have also been given capsule ig Tg forte now for one month.. is it helpful

thanks
doctor
Answered by Dr. Prof. Kunal Saha 14 hours later
Brief Answer:
Your problem is hard to solve. Finding solution would not be easy.

Detailed Answer:
Thanks for writing back. Sorry for the inadvertent delay in responding.

1. Getting a good second opinion would be hard. You should consult a gynecologist.

2. The cut off blood supply cannot be reconnected and so providing any sort of solution would not be easy. I do not see an easy way of solving the problem. Lets see if the gynecologist can suggest.

3. I do not think that a repeat surgery would be of any use. Cutting out the area of fat necrosis may not solve the problem completely. Let us see what the gynecologist has to say. I doubt if TB is involved. The role of immune system is only indirect.

4. I do not suppose cancer has anything to do with this. Fat necrosis is not a common finding.

5. Ig Tg Forte contains colostrum derivatives. Not sure if it would be of any good but you can give it a try.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4439 Questions

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