Question: can u plz explain the findings of my reports??? and old explain the mode of treatment nd future course of action

Thanks doctor

I had my csec delivery 2:5 years back.. Right from day 1 I had some difficulty in my right area where the pfannestial incision was done.. Three months later I developed a sinus track from properitoneal space to skin in right lower quadrant of abdominal wall that was doubted of tb(encl report) then att was started in April 14(csec-- Nov 14)att was then given for a year till April 15..again in May 15 I was having discomfort which was slowly radiated to left also... The USg done said its intralobular subcutaneous edema again after a month from July onwards att started again which I m still taking (macox plus600 and levomac 500)


in july a sceond opinion was taken and that usg showed fat necrosis and panniculitis,however my doc continued att,but somewhere down the line i feel had it been tb was it possible that it may have gradually radiated to left side also..

then an mri was done that showed pelvic peritoneal adhesions enclosing report mri dtd march and that doc communicated me verbally that fat necrosis mentioned in usg is still there neither increased nor decreased.but didnt mention that in report.my gynae wasnt convinced and asked for a rereview of report from another radiologist (whose report was enclosed in ist quesion)

i have difficulty in sitting sleeping and daily activities .sometimes my pelvic movements are also restricted.i feel heaviness and tightness and discomfort in lower abdomen

based on all my history i have three doubts if that can be ruled out


1.cellulitis/drug resistant tb I was treated for cellulitis also in XXXXXXX 15

2 fat necrosis/autoimmune disorder

3 any suture fragment related allergy/cancer


also my gynae has asked me for a repeat mri and wants to proceed for daignostic lap...is that safe doctor if there is any of the above mentioned


prob;em and is diagnostic lap a right procedure for the problem related to subcutaneous fat of abdomen ......also will taking tablets like chymoral br for some long time help me(since i really want to avoid surgery)also doctor i have a history of chronic bronchitis and severe allergies...pls guide doctor

brief history
c sec---nov 14
ist usg ----feb 15(that doubted of tb)
ist mri----feb 16(it showed a sfoft tissue track in same area and adhesions in sigmoid colon and left ovary
att started---april 15 to aprll 16
iind usg----may 16 (Intralobular subcutaneous edema)
att started again ---july 16 to present
second opinion usg oct 16(that showed fat necrosis and panniculitis)
mri march 16 pelvic peritoneal adhesions
may 16 rerevied report enclosed

thank for ur reply
artefact means a possibility of something but actually nothing specific being found. As is proved in your case. But since there is history of anti-tubercular treatment that is ATT for abdominal wall sinus tract and you have pain at the same site which showed the artefact there may still be a problems in the area of pain:
The possibilities I can think of are:
1......Scar in the fascia which has to be opened up for LSCS in every case or may be a stitch/thread granuloma. With the history of TB in the abdominal wall and sacroiilitis still present the possibility of tuberculosis is still there although may be a sequel of it.
2.....Fat necrosis: not uncommon in female patients.
Sometimes a free fat can act as a foreign body and can cause pain and tenderness.


1...doc it thst possible that a retained suture/thread granuloma has presented a picture like this and not tb causing a sinus tract(as there WAS never any discharge from the track) and i had skin marks tenderness warmth and fever during that time))))) AND THIS FAT NECROSIS IN SUBCUTANEOUS FAT????


2..ISthere any cure for fat necrosis (i mean taking any enzymatic prepartion for some months regularly like chymoral etc ar any anti allergic medicines or surgery is the only way to cure this?????