A male aged 50 years who is a k/c/o Old Pulmonary Koch's (Completed ATT course for 6 months one year back) p/w complaints of Abdominal Distension and Pain Abdomen with severe body weakness with much decreased appetite since last 1 month....his USG images are given alongwith findings....Comment on his Images and discuss the classical findings leading to his symptoms

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Most important thing take single drug at a time and not all drugs in single dose .it is hepatotoxic .pyrazinamide for 2 months only neurobion fort is must throughout treatment to avoid peripheral neuropathy. Addition of extra protein is advisable .

Ascitis Thickened peritoneum Enlarged mesentric lymph nodes Ascitic fluid analysis with biopsy of lymph node biopsy to confirm the diagnosis ?Kochs abd

KOCH'S ABDOMEN P/o tuberculosis completed ATT P/w free fluid in peritoneal cavity that is ASCITIS with thickening of parietal peritoneum and mesenteric lymphadenopathy significant Needs excision biopsy of mesenteric lymphnode as well as of peritoneum He will be put on ATT again in cat2

Thanx dr Dinesh Gupta
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Ascitictapping omental node biopsy CT abdomen with pelvis prostate wt prevoid post void urine PSA ideal prostate markar biopsy & tapping while CT fluid for cbnat mostly Koch's abdomen with prostomegaly

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Free fluid under peritoneam Increase peritoneal thickness Omental lymphadenopathy H/o PTB C/o abd.distension Weakness weight loss D/d abd. /intestinal tuberculosis Adv. Fluid tapping further investigations

Ascites.fluid tapping.start Tab.liv 52Ds, restricted salt diet,protein rich diet.biopsy is necessary

Ascits Lymph adenopathy ? Tubercular Ad Ascitis fluid tapping & HPE Exam & C/S Lymph node biopsy for diagnosis

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