April 2013--Patient was evaluated in PCMS, Bhopal a few weeks
later after she posted her inputs to the website. The history was
re-assessed and it was found that currently the patient was complaining
only of regular diffuse mild abdominal pain not severely restricting her
activities (and yet was producing enough discomfort for the parents to
have made a 2000 kms journey to PCMS Bhopal from their residence in
North Bengal. The low grade fever, pain abdomen and vomiting intermittently had been there 6 years back only for a few months. For
a better investigation of her current recovery from the possible
tubercular strictures for which she had already been treated with a full
course of anti-tubercular therapy we planned a CT enterography using negative contrast with 1.5% mannitol and it
revealed the same strictures earlier visualized on barium but with
better visibility of the calcification suggestive of fibrosis along with
the 3D reconstructed image providing a possibly better view for the
operating surgeon. (See http://care.udhc.co.in/INPUT/displayIssueGraphically.jsp?topic_id=227 for the images).
The dilemma of whether to operate on her as
her symptoms were not suggestive of marked obstruction remained and she
was discharged on April 2012 and asked to be on active follow up with
regular status updates about her abdominal pain through the web site. On last follow-up this first week of may 2013 she still continues to have the diffuse mild degree of abdominal pain without any symptoms suggestive of obstruction.