Computed tomographic features of abdominal tuberculosis: unmask the impersonator!

Journal Article · Tue Jan 15 04:00:00 EST 2019 · Abdominal Radiology (Online)

DOI:https://doi.org/10.1007/S00261-018-1700-3· OSTI ID:22923173

Purpose: Abdominal tuberculosis (ATB) mimics various infectious, inflammatory, and neoplastic conditions and hence requires a high index of suspicion for accurate diagnosis, especially in low prevalence areas. It is difficult to consistently establish a histopathological diagnosis of ATB which underlines the importance of supportive evidences for institution of prompt empirical therapy to prevent associated morbidity and mortality. Methods: We retrospectively evaluated clinical and imaging features of 105 ATB cases and classified their CT findings based on peritoneal, lymph node, bowel, and solid organ involvement. Concomitant pulmonary and extra-pulmonary involvement was assessed. Results: Abdominal pain (78.1%) followed by fever (42.9%) were the commonest presenting symptoms. Peritoneal TB (77.14%) most commonly presented with a mix of ascites (49.38%), peritoneal (28.40%), and omental involvement (27.16%). Lymphadenopathy (57.1%) most commonly presented as necrotic nodes (81.67%) at mesenteric, peripancreatic, periportal, and upper paraaortic regions. Commonest site of bowel involvement (cumulative of 62.85%) was ileocecal region, with the commonest pattern of involvement being circumferential bowel wall thickening without bowel stratification with mild luminal narrowing. Hepatic (13.33%) and splenic (16.2%) involvement predominantly presented as multiple microabscesses. Adrenal and pancreatic involvement was noted in 4.7% and 1.9% of patients, respectively. 38.1% patients showed concomitant pulmonary and extra-pulmonary TB. Conclusion: ATB has varied radiological features; however, peritoneal involvement in the form of mild ascites, smooth peritoneal thickening, smudgy omentum, multi-focal bowel involvement, necrotic nodes, and multiple visceral microabscesses point towards a diagnosis of ATB in appropriate clinical setting.

• OSTI ID: 22923173
• Journal Information: Abdominal Radiology (Online), Journal Name: Abdominal Radiology (Online) Journal Issue: 1 Vol. 44; ISSN 2366-0058
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ASCITES
COMPUTERIZED TOMOGRAPHY
DIAGNOSIS
DISEASE INCIDENCE
FEVER
INFLAMMATION
LIVER
LYMPH NODES
MESENTERY
MORTALITY
PAIN
PANCREAS
PATIENTS
PHENOBARBITAL
TUBERCULOSIS