Tuberculosis of pubic symphysis presenting with hypogastric mass.
DJ Balsarkar, MA Joshi
Department of General Surgery, LTMMC and LTMG Hospital, Sion, Mumbai - 400 022, India., India
D J Balsarkar
Department of General Surgery, LTMMC and LTMG Hospital, Sion, Mumbai - 400 022, India.
|How to cite this article:|
Balsarkar D J, Joshi M A. Tuberculosis of pubic symphysis presenting with hypogastric mass. J Postgrad Med 2001;47:54-54
|How to cite this URL:|
Balsarkar D J, Joshi M A. Tuberculosis of pubic symphysis presenting with hypogastric mass. J Postgrad Med [serial online] 2001 [cited 2023 Feb 7 ];47:54-54
Available from: https://www.jpgmonline.com/text.asp?2001/47/1/54/232
A 28-year-old male patient presented with a swelling in the hypogastrium since one and a half months associated with a history of chronic cough, anorexia and weight loss. There was no history of tuberculosis in self or contact with patient with tuberculosis. On examination there was a 5 x 5 cms soft, intrapariet al swelling in the hypogastrium. A clinical diagnosis of haemangioma of the pariet al wall of the hypogastrium was made.
X-ray of the pubic bones showed bony erosion of the public symphysis [Figure:1]. Ultrasonography showed a 5 x 4 cms intrapariet al swelling in the hypograstric region. Computerised tomographic (CT) scan of the abdomen showed a 5 x 5 cms intrapariet al swelling in the hypograstrium with erosion of the public symphysis [Figure:2]. CT guided needle aspiration of pus showed presence of acid fast bacilli. Fluid adenosine deaminase level was 284 U/L (normal of 0.1-22 U/L). Patient was started on antituberculous drugs and he showed good response. The hypogastric mass disappeared three months after treatment.
Pubic bone is an exceptional site of tuberculous infection., Early diagnosis is essential before destructive changes set in. Clinical signs noted are inflammatory pain in the pubic region and a hypogastric cystic mass.,
Present case had a hypogastric lump. X-ray of local part shows irregular osteolysis of pubic bone, as was noted in reported case. CT scan helps in confirming the diagnosis by demonstrating the presence of cystic mass with destruction or erosion of the pubic bone, as was well documented in the present case. Confirmatory diagnosis is by demonstration of acid fast bacilli from pubic foci-aspirate. Raised fluid adenosine de-aminase levels help in supporting the diagnosis of tuberculosis. The treatment of choice is a short course of anti-tuberculous drugs for six months.
Diagnosis of pubic tuberculous osteoarthritis should be considered in unexplained causes of pubic pain especially in endemic countries.
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