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?
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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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