10years old female h/o abdomen distended with pain on & of since 15days



Abdominal distension, Pain off & on 15 days. C.T. Abdomen : Mesenteric Lymphadenopathy. Work up for T.B. ESR. C.B.P & MC. Abdominal Tuberculosis.

looks like abdominal tuberculosis..r/o pulmonary focus if any.. confirm diagnosis and then start ATT regimen. Please do contact tracing family members and other close contacts to r/o TB in them

it could be a case of abdominal tuberculosis....but pain component may still persist even after putting on ATT. . barium meal follow through is must to rule out mobile cacecum as adhesions persist....it causes intractble pain.....Surgery may be needed to break adhesions in order to relieve pain...

abdominal tuberculosis..do confirmation by cbnaat of gastric aspirate ..do contact tracing of family members by x-ray chest..start ATT along with steroids..nd symptomatic nd supportive therapy

no steroids test ok

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definitely gonna need a basic work up, chest x-ray , sputum AFB , ascitic fluid tap, gene expert study. also a surgical opinion , if possible for the adhesions . if dx in favour , gor for att ,,(seeing whether pulmonary with extra pulmonary feature or simple extra pulmonary type ) . f/ b contact tracing . if any child less than 6 yrs in family , definitely do a mantoux ,chest x-ray n r/ o that child as well . for adults as well the same will suffice ..

it's clear cut case of abdominal tb.to start of att with steroids.with ascitic fuild analysis

why steroid here ?

start with akt..but steroids are at present not indicated. ...confirm by ascitic tap and send it for gene xpert test...will tell u about rifampicin resistance too

abdominal Koch's

koch's abdomen..ascitic fluid tap for cyto and biochemistry..and microbiology, mx test,chest x ray

do all investigations then start AKT

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