(Repeat) constant ascites from intestinal TB for more than 6 weeks?
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1.the history of the ailment
-55 yrs, male
-The patient had teeth implant with operation in the gum
in Jan. 2006
-His abdoment swallen sometime but he didn’t think about
ascites since beginning of 2006
-Some pain on his waist since last July
-Some ooze from belly button in July but cured soon after
application of penicillin ointment
-He took oriental medicine since Febraury.
-May this year, he started to have ascites, losing appetite
and hospitalized
-Taking out 12 ltrs of water from the abdomen
2.diagnosis
-Dr.s diagnoses him as TB with symptoms but failed to
discover germs instead found ulcer inside the large intestine
-TB streches to peritoneum, intestine
-Having thorough check with CT, Endoscope extracted
sample check of cells, Dr.s found no evidences for cancer
-Dr.s don’t know the cause of ascites
3.medication
-Inh, rfp, emb, pga
4.present situation
-ascites,weak urine,no appetite,weight loss
Question : What is the cause of lasting
ascites in the following case?
1.Background of the ailment(55yrs,
male w/ diabet)
-He had teeth implant in Jan. 2006,
since then, his abdoment swollen
sometimes
-Some pain on his waist since last July
-Ooze from belly button in July but
cured soon after application of
penicillin ointment
-May this year, he started to have
ascites, losing appetite and
hospitalized, taking out 12 ltrs of
water from the abdomen
2.diagnosis
-Dr.s diagnoses him as TB with
symptoms but failed in discovering
germs instead found ulcer inside the
large intestine
-TB streches to peritoneum, intestine
-Having thorough check with CT,
Endoscope, extracted samples of
cells from various parts of organs,
no traces for cancer found
-Yet the cause of ascites unknown
3.medication
-Inh, rfp, emb, pga
4.situation
-weak urine,no appetite, weight loss,
diabet
What are you trying to find out? I don’t see a question that needs answered.
You seem as if you don’t agree with the Dr. s diagnosis of Abdominal TB? Maybe you need some differential diagnosis?
Ascites is a condition where excess fluid collects in the space within the abdomen called the peritoneum and can result from serous (proteinacous substances), haemorraghic (blood), or tumour cells collecting within that area.
It can be due to a complication from a variety of conditions and present as a symptom for even a larger number of diseases.
>Heart Disorders< Pericarditis
Cor Pulmonale
Heart Failure
>Liver Disorders< Liver cirrhosis
Hepatitis
Obstructive Jaundice
>Kidney Disorders<
Nephrotic Syndrome
(to name a few)
I’m presuming they would have ruled out all the above with preliminary physical examinations, blood tests (Complete Blood Count, Blood Film, Urea and Electrolytes, Blood Culture), urine tests and lab tests (Chest Xray, ECG, Abdominal Ultrasound etc)
The Dr.s seem to have ruled out abdominal cancers by doing cytology (test on cells). But how about a metastatic cancer (cancer that spread)? If it’s small enough it may not be picked up on a Abdominal CT (If that was what was done) and a full body CT or MRI could be done.
Also how about immunoproliferative conditions like multiple myleoma or malignant lymphoma?
Hope this helped in some way
P.S. Couldn’t quite figure out what the medications represented. inH and rfp are probably isoniazid and rifampicin which is used to treat TB; not sure about the others
What in the world is your question???? Are you trying to get someone to do your homework assignment?