A 20years old female patient came in my chamber, complain with pain abdomen pain at left hypochondriac region, nausea with vomiting, xerostomia,dysphagia. O/E BP 120/60mmhg pulse 90bpm USG show multiple enlarged mesentric lymph nodes further investigation I advise CBC seum uria seum creatinine seum amylase serum lipase LFT but before this Inj. pantop iv twice a day inj. Pipzo 4.5gm iv twice a day inf. Metrogyl iv thrice daily inj. Dilona im sos Tab. Chymoral forte 1 tab. thrice daily nill orally IV FLUIDS 5% RL advise further management
Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!
Most likely a case of abdominal tuberculosis. Get a CECT abdomen and CT guided F.NAC of abdominal lymph nodes. An ESR , montaux test, X - ray chest to evaluate.
Most common cause of mesenteric adenitis is yersinia enterocolitica . Abdominal tuberculosis can also lead to it's enlargement . Just go for cbc CRP urine r/e n c/s. If there is history of contact with tuberculosis or other symptoms guiding towards u have to rule it out too . Add probiotics too . Analgesic anti inflammatory round the clock .
A young patient with multiple enlarged lymph nodes suggest either infection or tuberculosis. So please do x ray chest examination and wbc tc dc Hb and esr with blood sugar examination. Meanwhile you can treat her with antibiotics like ceftriaxone and sublactum with inj.metrogyl and inj.pantaprozole with inj.onden.with analgesics and antispasmodic drugs.you may concentrate later on malignancy and other things if she doesn't respond to abovementioned management.
In most cases, mesenteric adenitis is self-limiting, and typically abates over the course of a few weeks, still your radiologist is not saying whether these are matted or not also not saying any thing about any bowel wall thickness ,not even saying anything about size of node and echotexture of nodes ,seeing xerostomia and dysphagia your pt may have iron deficiency anaemia ,we need some symptomatic treatment only till we get relevant reports
Tb
Ansari sir, do cbc esr, mountax test, and genexpert and cxr, may be extra pulmonary Koch's,
CBC, esr,mt,cxr,ct abd and ct guided fnac Ofloxa ornida,PPI, tramadol, lactulose sos Ceftriaxone iv
CT GUIDED FNAC BLOOD ESR MANTOUX TEST CXR
Most likely it is abd TB...mantoux and sputum AFB...often these reports come out to be negative..the best modality is guided FNAC from the node and ascitic fluid and send that for CBNAAT and other profiles of TB and culture sensitivity....treat accordingly...
Cases that would interest you
- Login to View the image
8yrs/F Since 4 month's Abdominal pain CBC..... Normal... HB........9.9% Mx Test.... 5mm*6mm.... 48 Hr. Dx...? Rx...? Plz Better Suggestion.....
Dr. Junaid Alam3 Likes13 Answers - Login to View the image
hi she is 7yrs old ...she complaints stomach pain,loss of appetite ,stomach wer swollen lightly...started with oflox,colimex,aciloc RD,orally...any suggestions???
Dr. Anjum1 Like9 Answers - Login to View the image
A 4 years old boy, complaining č severe pain abdo. with continuing vomiting. Rectal bleeding č fever č xerostomia. O/E Temperature 103° Pulse 110 bpm R/R 28 bpm Spo2 84% Chest B/L clear
Dr. Maqusud Ansari2 Likes14 Answers - Login to View the image
19 yr old female pt. comes with evening time severe nausea for 20 day then it get relieved itself after 20 days..pt also gives history of cough and fever for 7 days ..pt also gives history of pain abdomen at different locations mild in intensity..pt also gives history of weight loss...no history of blood in stools or malena ...on examination pallor is present ..abdomen examination is normal.. on USG inflammed terminal ileum is seen ..report is enclosed within
Adeel Kazmi1 Like23 Answers - Login to View the image
A 15 yrs old girl came with C/O. Pain in abdomen since 3 day's No any other complain
Dr. Ansari Abuzar1 Like20 Answers
6 Likes