Abstract
BackgroundAbdominal tuberculosis (TB) is endemic in the developing world and is reemerging in the West. Since computed tomography (CT) has the ability to demonstrate changes in the peritonium, mesentry, lymphnodes, bowel and solid organs and is being increasingly used for primary evaluation of abdominal conditions, it is important to be familiar with the CT features of the disease.MethodsCT findings were retrospectively analysed in 49 patients with proved abdominal TB. Patients with genitourinary TB and with AIDS/HIV were not included in the study.ResultsPeritoneal involvement was the most common feature (77.5%) with ascites (wet peritonitis) seen in more than half the cases (55.2%). The rest showed peritoneal, mesenteric or omental thickening or mass formation but no ascites (dry peritonitis). Other findings included lymphadenopathy (46.9% mainly of diffuse nature, bowel wall thickening (38%) and solid organ involvement (20.4%).ConclusionsCT reliably demonstrates the entire range of findings which need interpretation in the light of clinical and laboratory data.
Highlights
Abdominal tuberculosis (TB) is endemic in the developing world and is reemerging in the West
Tuberculosis (TB) is a re emerging global emergency which is further complicated by AIDS/HIV infection and the use of immunosuppressant drugs [1]
It is important to be familiar with the computed tomography (CT) features of the disease and its complications
Summary
CT analysis of the pattern of abdominal TB revealed peritoneal involvement in 38/49 (77.5%) cases and was classified as "wet peritonitis" defined as free or loculated ascites of large or small volume, depending upon the depth of ascites (whether more or less than 3 cm respectively; Figs 1 &2) or "dry peritonitis" represented by peritoneal mesenteric or omental thickening or mass but without ascites (Fig 3). Majority of the cases (17/ 20; 86.8%) involved the small bowel, with or without the caecum. Perforation of the gut was seen in 3 cases, 2 of the large bowel leading to a parietal abscess in 1 patient [Fig. 6] and hydropneumoperitomium in the other. The third case was a perforating tuberculous gastric ulcer, resulting in an inflammatory mass of the lesser sac and the pancreas [Fig. 7]. A combination of these findings was seen in 21/49 cases (42,8 %) involving more than one system in varying combination
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