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Dr. Andrew Rynne
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Dr. Andrew Rynne

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What does this ultrasound report for abdominal discomfort indicate?

Answered by
Dr.
Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6010 Questions

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Posted on Tue, 6 Sep 2016 in General Health
Question: Hello. I want this to be answered by Dr. XXXXXXX XXXXXXX
Brief history
I had a cesarean delivery in Nov 14.post op I devloped abdominal discomfort.in Feb 15 an USG was conducted that revealed an hypoechoic track from properitoneal space to skin in anterior abdoimanl wall.it doubted of Tb..bassed on positive igra mantoux nd USG att was started in april 15..took art for one year now till april 16..again swelling started ..may 16 USG now revealed subcutaneous edema..in infraumblical arae what could be the reasons for this..is it cellulitis panniculitis or reoccurence of tb..pls guide m attaching my both USG as well as latest blood reports..are they pointed towards tissue necrosis again..pls help what should I do
Also one more usg was conducted on 18th july 2016 that pointedbtowards fat necrosis..i m attaching the complete usg included pic and reports of previous usg. pls guide on my usg reports
Can this be suture granuloma ,,pls guide mam
doctor
Answered by Dr. Aarti Abraham 14 minutes later
Brief Answer:
As below

Detailed Answer:
Hello
Thanks for trusting me with your issue.
Dr. Aarti here.
I can see only the blood reports that have been uploaded.
Please upload the scans too.
Looking forward to hearing from you.
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham 1 hour later
Thanks mam

Attaching my reports.pls show me the right path to proceed.
doctor
Answered by Dr. Aarti Abraham 13 hours later
Brief Answer:
As below

Detailed Answer:
Hi
I have gone through the reports dear.
The latest ultrasound scan shows no abnormality.
It is completely normal, right ?
Just showing few adhesions , that means after surgery, the uterus is slightly stuck to the abdominal wall.
So why are you worried ?
Are you having pain, swelling or other symptoms ?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham 27 hours later
Yes doc I m having swelling and discomfort
Below the navel area.mam have u checked the second page of my 18 July 16 USG that terms fat necrosis and inflammation point..

My only concern is this reoccuring edema that came in may ultrasound after leaving att in april 16..also I m having almost the same symptoms that I used to have last year wen this track was devloped.


Mam can u pls tell that whether cellulitis or suture granuloma can present picture like this or is this really reiccurence of Tb,because the radiologist who conducted my may 16 USG told me that it is cellulitis and reoccurence of Koch ,but the problem is that no doc is beliveing..i have bloating and indigestion also now

I m also attaching a single pic of my mri that took place after may16 USG but thy didn't reveal any edema but some scar type thing and adhesions..if u can pls see and chk is that what is causing me hardness and discomfort..my scar is totally fine but problem is in between the area below navel and above scar..w

What are the treatment options available for me..pls guide mam.i have lost hope
doctor
Answered by Dr. Aarti Abraham 14 hours later
Brief Answer:
As below

Detailed Answer:
Yes, I went through the second page right now.
It shows possibility of fat necrosis and inflammation point.
I do not think at all that this is recurrence of the edema that occurred.
It is definitely suture granuloma I think , and not TB.
You have already taken full blown treatment of TB already, and it cannot recur now.
It is adhesions and suture granuloma.
I can understand your distress and discomfort.
The options for you now involve taken a long course of antibiotics and anti inflammatory drugs to resolve the inflammation.
If that does not work, you should consult an expert surgeon to remove that area of necrosis and granuloma.
If it is surgically removed, you will feel a lot better.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham 38 hours later
Thanks mam

I m in regular follow up of my Gynae also..and yesterday she prescribed me some medicines after physical examination and keeping in view of my history.I m attaching that ..I think she is in doubt of both scar site endometriosis and reoccurwnce of Tb for which she has asked me to take to resolve the lingering infection..pls guide mam is this right..other wise the second option that she gave me is of diagnostic lap
..is a gymaec endosurgeom right person to deal with this.
What should I do now..

What kind of long antibiotic course can u suggest and the anti inflammatories though I have taken them a lot...
As per my Gynae the Tb treatment sometimes have to be taken for 2 to 3 years to prevent fibrosis..is it true

Also she has given me hirudoid cream to apply locally..can l do that mam if again this att is started which is now macox plus and levoflaxacin I guess is this fine ..can this lead to drug resisitance

If this is suture granuloma or necrosis will theses medicines work attached prescription

Also someone suggested me to take homeopathy for my problem ..can I take that with these above mentioned medicines ..if u can pls guide in detail I will be greatful
Mam am I on right line of treatment..pls tell as I don't have further follow up left..
One thing I forgot to mention that I don't used to have any periods problem till april also but might be because of this growing edema I feel very bloated tight and discomfort in that mentioned arae..can u pls explain me my position..do I have any chances of survival because one of radilogist advised me to not go for any surgical intervention since this will then become impossible to heal...i devloped herpes in my arm in march also and keratisis in my eye last year which still has not been helaed properly..i know i have asked lots of question by pls if u can understand my ongoing dileema..

Will it be safe to operate or ho for diagnostic lap in case it is Tb and not suture granuloma or something else
doctor
Answered by Dr. Aarti Abraham 15 hours later
Brief Answer:
As below

Detailed Answer:
Please answer the specific questions listed below, since I really understand your discomfort, and I want to give you correct guidance .
Also, please do not resort to homeopathy, there is no role of homeopathy here.

1. Do you have pain, swelling and discomfort related to periods ?
2. Are your periods regular ?
3. Is there a lump or visible area on the skin between the navel and the scar ? Any redness ?

4. Do you have redness or discharge from the scar or anywhere around it ?

5. Can you attach the operative details ( operation notes written by the Gynec who performed your cesarean section ) . If not, can the gynecologist be asked what suture materials she used for the rectus sheath and the skin ?

6. Was any MRI done recently , in 2016 ?

I really do not think it is TB.
Once you tell me these details ( answer them one by one and in details ), I will guide you for further laparoscopy or surgery.

Also, where do you reside, I can suggest the best person for it for you.
Please do not get panicky or distressed, this is a problem but there is always a solution if you reach the right person.
Take care, and have faith.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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