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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Could I be worry about CT abdomen information ?

CT ABDOMEN‎ Clinical Info‎: ‎generalized abdominal pain for the last ‎04 ‎months‎. ‎Chronic gastritis‎. ‎Ultrasound ‎ shows thickening of small bowel loops‎. ‎Weight loss‎. ‎? ‎Abdominal tuberculosis‎. ‎ 8 ‎mm‎, ‎post oral‎, ‎pre and post intravenous contrast‎, ‎axial images through abdomen are submitted‎.‎ Basilar lungs are clear ‎& ‎no pleural effusion ‎/ ‎thickening is noted‎. ‎Liver is homogenous with no focal ‎ lesion‎. ‎No intra or extra hepatic cholestasis is noted‎. ‎Gall bladder without opaque cholelithiasis is ‎ normal‎. ‎Spleen‎, ‎pancreas and both adrenals ‎& ‎kidneys are normal‎. ‎Soft tissue density thickening ‎ in the distal ileum noted‎. ‎This is causing indentation on cecal contrast column‎. ‎Rest of the ‎ small and large bowel loops are unremarkable‎. ‎This approximately measures ‎2‎.‎4 ‎x ‎2‎.‎0 ‎x ‎ 2‎.‎3 ‎cm ‎(‎CC x AP x TR‎) (‎evident images ‎# ‎33‎-‎35 ‎+‎C‎)‎. ‎Opacified abdominal aorta‎, ‎IVC‎, ‎portal ‎ vein ‎& ‎mesenteric vessels are normal‎. ‎No evidence of abdominal free fluid or adenopathy is ‎ recognized‎. ‎Bony skeleton ‎& ‎soft tissues are intact‎. ‎ CONCLUSION‎:‎ Findings are suggestive of infective etiology involving distal ileum‎. ‎Clinico‎-‎lab‎. ‎correlation and ‎ further evaluation by small bowel follow through examination is recommended‎. ‎ I want to know whether patient has intestinal TB or not?
Fri, 24 Jun 2011
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Orthopaedic Surgeon 's  Response
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He needs to get a few tests done like PCR which is expensive but will confirm presence or absence of Tuberculosis. Also since there is weight loss it is better to get started on Anti-tubercular treatment anyway and there will be relief. Patient needs to eat protein rich food like cereals, oats, pulses, eggs, chicken, lean meat. Drink enough water 1-2 litres a day. Patient can be started on Government ATT therapy by RNTCP approved Doctor at a Hospital. Do not delay. Better to be safe than sorry later.
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Dr.A.K.Singh's  Response
chronic gastritis,thickened bowel loop,weight loss hmmmmmmmm simptoms ressemble?????????????? IT.no lymphedenopathy reported.go for IgG,IgM,THEN GET CLEAR PICTURE
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