Diagnosis Of Abdominal Tuberculosis Research Articles

Diagnosis of abdominal tuberculosis: Detection of mycobacterial CFP-10 and HspX proteins by gold nanoparticle-PCR amplified immunoassay

Attempts were made to improve the efficacy of PCR amplified immunoassay (I-PCR) for diagnosing abdominal TB cases by utilizing the gold nanoparticle (AuNP)-based I-PCR, where AuNPs were functionalized with detection antibodies/oligonucleotides that exhibited 84.3% sensitivity and 95.1% specificity. This assay would improve the ongoing algorithms used in abdominal TB diagnosis.

Meta-analysis of diagnostic accuracy of nucleic acid amplification tests for abdominal tuberculosis.

Abdominal tuberculosis (TB) is a severe extrapulmonary TB, which can lead to serious complications. Early diagnosis and treatment are very important for the prognosis and the diagnosis of abdominal TB is still difficult. We searched PubMed, the Cochrane Library, Embase, China National Knowledge Infrastructure, and the Wanfang database for studies evaluating the diagnostic accuracy of NAATs for abdominal TB until August 2020. Any types of study design with full text were sought and included. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. Subgroup analysis, meta-regression analysis and sensitivity analysis were used to explore the sources of heterogeneity. Stata version 15.0 with the midas command packages was used to carry out meta-analyses. We included a total of 78 independent studies from 53 articles; 64 with CRS as the reference standard, and 14 with culture as the reference standard. The pooled sensitivity, specificity, and the areas under summary receiver operating characteristic (SROC) curves (AUC) were 58% (51%-64%; I2 = 87%), 99% (97%-99%; I2 = 81%), and 0.92 (0.89-0.94) compared with CRS, respectively. The pooled sensitivity, specificity, and the AUC values of the SROC were 80% (66%-90%; I2 = 56%), 96% (92%-98%; I2 = 84%), and 0.97 (0.95-0.98) compared with culture, respectively. The heterogeneity of sensitivity and specificity was significant. NAATs had excellent efficacy in the diagnosis of abdominal TB regardless of the reference standard and regardless of the subtype of abdominal TB. Multiplex PCR with multiple target genes may improve diagnostic sensitivity, and stool specimens may also be used for the diagnosis of abdominal TB in addition to tissue and ascites.

Abdominal tuberculosis in patients with acute abdomen: an observational single centre study

Background: Abdominal tuberculosis tends to present with nonspecific features and can be hard to diagnose. Abdominal tuberculosis can mimic a variety of other abdominal conditions and only a high degree of suspicion can help in the diagnosis, otherwise, it is likely to be missed or delayed resulting in high morbidity and mortality. Therefore, a high index of suspicion, fortified with a general degree of awareness and knowledge of this form of the disease is essential. Methods: A careful history taking, and thorough clinical examination was carried out in each case. All the patients were investigated. Some of the patients needed surgical intervention. For patients who responded favorably to conservative management and did not require surgery, diagnostic studies were carried out to confirm the presence of abdominal tuberculosis. Results: Abdominal tuberculosis constituted a significant percentage (23.6%) of all cases attending the emergency with an acute abdomen. Ultrasound and CECT can show various findings which can be suggestive of abdominal tuberculosis, but there is no significant difference in PPV of ultrasound and CECT abdomen. Colonoscopy has PPV of 55.6% in diagnosis of abdominal tuberculosis. Gene Xpert is significantly better than AFB staining in diagnosing the abdominal tuberculosis with ascitic fluid examination. Conclusions: Good clinicopathological workup in patients of abdominal tuberculosis results in earlier diagnosis and prompt management of this curable disease. Ultrasound and CECT can be suggestive of abdominal tuberculosis, but final diagnosis can be made only after histopathological examination/with gene Xpert report.

A RARE CASE OF OVARIAN CARCINOMA WITH SUSPICION OF ABDOMINAL TUBERCULOSIS PRESENTING AS ACUTE ABDOMEN IN A YOUNG FEMALE

Aims And Objectives The differential diagnosis of peritoneal tuberculosis and ovarian carcinoma is difcult at times because of overlapping clinical and lab ndings. Also, ovarian carcinoma presenting as torsion ovary is rare. Methods A 24yr old female with complains of lower abdominal pain since 10 days, history of weight loss and loss of appetite since 2 months, presented with acute lower abdominal pain and vomiting since 2 days with CECT report showing right adnexal tuboovarian mass of 8*5.4*6.2 cm with ileocaecal thickening. Patient was kept on conservative management for 2 days considering the diagnosis of abdominal tuberculosis. Tumour markers were CA-125- 201.6, CA19-9-952.5, betaHCG-24.09, Alpha fetoprotein-21.05. As patient continued to have acute pain in abdomen, MRI Pelvis was done to rule out ovarian torsion. MRI Pelvis- Right ovary grossly enlarged and twisted around the pedicle. Exploratory laparotomy was done with detorsion and removal of a solid ovarian mass. Histopathology report- Adenocarcinoma grade III. Management was done further by Chemotherapy. Results This was a case of adenocarcinoma ovary grade II in a young female which presented as ovarian torsion and was mimicking abdominal tuberculosis. Conclusion This case highlights ovarian cancer in young females with varied clinical presentation which causes delay in diagnosis and management. Ovarian carcinoma much be considered as a differential diagnosis in cases of abdominal tuberculosis and ovarian torsion

Diagnosis of abdominal tuberculosis by multi-targeted (mpt64 and IS6110) loop-mediated isothermal amplification assay.

Diagnosis of abdominal TB is an exigent task due to variable anatomical sites and non-specific clinical manifestations that closely resemble other diseases. Most of the available diagnostic modalities yield low sensitivities and need expertise to handle the specialized equipment. Hence, there is an urgent need to develop a rapid and reliable diagnostic test, so as to reduce the unnecessary morbidity. Therefore, we designed a multi-targeted loop-mediated isothermal amplification (MT-LAMP) for diagnosing abdominal TB. We evaluated an MT-LAMP (using mpt64 and IS6110) to diagnose abdominal TB within ascitic fluids and intestinal/peritoneal biopsies and compared these results with multiplex-PCR (M-PCR) using the same targets. MT-LAMP products were analyzed by gel electrophoresis and visual detection methods, that is, hydroxy naphthol blue and SYBR Green I reaction. Sensitivities of 80.9% and 84.6% were obtained in suspected (n=42) and total abdominal TB (n=52) cases, respectively by gel-based MT-LAMP, with 97.3% (n=37) specificity in non-TB controls. Notably, sensitivities attained by gel-based/SYBR Green I MT-LAMP in both clinically suspected and total abdominal TB cases were significantly higher (P<0.05) than M-PCR. Furthermore, sensitivity obtained with SYBR Green I was equivalent to that of gel-based MT-LAMP, while somewhat lesser specificity (94.6%) was attained with SYBR Green I, compared with gel-based MT-LAMP. Both gel-based and SYBR Green MT-LAMP exhibited equivalent sensitivities to diagnose abdominal TB. Because SYBR Green LAMP is easier to perform than a gel-based assay, we are currently focused on improving the specificity of this assay so as to develop a diagnostic kit.

Assessment of DNA aptamers targeting GlcB and HspX antigens for application in the diagnosis of abdominal tuberculosis

The diagnosis of abdominal tuberculosis (aTB) is challenging and there is an urgent need for an accurate diagnostic test. We have developed a high affinity DNA aptamer against GlcB antigen of Mycobacterium tuberculosis (Mtb). We further compared the diagnostic utility of in-house-generated high affinity DNA aptamers and polyclonal antibodies against two Mtb antigens, namely GlcB and HspX, in ascitic fluid samples. These diagnostic reagents were assessed in patients (n = 94) who were categorized as ‘Definite TB’, ‘Probable TB’, ‘Possible TB’ (taken together as aTB) and ‘Non-TB’ disease. Receiver operating characteristic curves were used to derive cut-off values to provide ≥93% specificity. Aptamer Linked Immobilized Sorbent Assay (ALISA) for HspX and GlcB exhibited a sensitivity of ∼84% and 50%, respectively (p-value <0.01). In contrast, antibody-based ELISA exhibited a lower sensitivity of ∼18% and ∼28% for HspX and GlcB, respectively (p-value <0.0001 and p = 0.05 for HspX and GlcB ELISA vs. ALISA, respectively). HspX ALISA detected 32/38 aTB cases, while Xpert detected only 9 samples. In conclusion, HspX aptamer-based test was found to be superior to the other tests for diagnosing aTB and it nearly fulfils the sensitivity criteria of WHO's ‘Target Product Profile’ for extrapulmonary tuberculosis (sensitivity ≥80%, specificity 98%).

Clinical case of late diagnosis of abdominal tuberculosis

Clinical case of late diagnosis of abdominal tuberculosis

A rare complication of the great mimicker: free tubercular ileal perforation

Primary intestinal tuberculosis is an uncommon form of extra-pulmonary tuberculosis. With non-specific manifestations, unusual presentations and no proven superior diagnostic modality, differentiation and diagnosis of abdominal tuberculosis is a difficult scenario. Undiagnosed, untreated cases may present with complications. Free perforation of small bowel due to tuberculosis is a rare complication (1-2%) because of adhesion formation and reactive peritoneal thickening; however, when it occurs is most feared for its association with high mortality. We report a case of an elderly male who presented with features of intestinal perforation, treated with emergency surgery and diversion ostomy for small bowel perforation which was diagnosed post-operatively to be of tubercular etiology. Acute care surgeons may be trapped in diagnosing such cases with its non-specific imaging findings, and hence must maintain a low threshold for surgical intervention in the emergency setting.

Abdominal tuberculosis requiring surgical intervention: A 10-year single-center experience

Background: Although uncommon in children, abdominal tuberculosis (ATB) can be a life-threatening condition with a subset requiring emergency surgical intervention. This study aims to determine the presentation, surgical procedures performed, and outcomes in children affected by abdominal tuberculosis. Methods: A retrospective chart review of all children undergoing surgical intervention for ATB from July 2007 to December 2018 was conducted. Data were analyzed using SPSS version 22. Results: Of 340 children with a diagnosis of ATB seen at the Indus Hospital’s TB clinic, 14 (4%) underwent laparotomy. Females were affected more commonly (57%), with a mean age at presentation of 11 years (range 8-14). Nine children required laparotomy for documented perforation, while 5 had an intestinal obstruction. Most children (n=10) had an established diagnosis of ATB before the surgical intervention; 2 children had completed 6–9 months anti-tuberculous treatment (ATT) courses, while 8 children had been on ATT for a mean period of 2.5 months at the time of developing acute surgical symptoms. Diversion ileostomy was made in 64%. Postoperative complications included sepsis (n=4), wound infection (n=3), abdominal collection (n=2), enterocutaneous fistula (n=2), and abdominal wound dehiscence requiring formal closure (n=2). There were 4 mortalities (29%); 10 patients were discharged after a median in-hospital stay of 12 days (range 6-35) of which 6 with ileostomies underwent reversal after completion of the ATT course. Conclusion: ATB has high morbidity and mortality. Perforation and obstruction can occur during or after the completion of ATT. Management requires early recognition and surgical intervention as indicated.

Clinical features of and diagnostic approaches for abdominal tuberculosis: 5-year experience from a non-tuberculosis-designated hospital in China

abdominal tuberculosis (TB) is a common form of extrapulmonary TB but it is still a diagnostic dilemma in clinical practice. This study aimed to highlight the clinical features and diagnostic approaches for abdominal TB. seventy cases of diagnosed abdominal TB were retrospectively collected between August 1st, 2015 and June 30th, 2020. They were classified as peritoneal TB, lymph node TB, gastrointestinal TB, visceral TB or mixed TB. eighteen patients were diagnosed with peritoneal TB, nine with lymph node TB, five with gastrointestinal TB, two with visceral TB and 36 with mixed TB. More than 65 % of the patients had tuberculosis of other sites except the abdomen. The median diagnosis time was 60 days. Ascites (58.6 %), abdominal distension (48.6 %), weight loss (44.3 %) and fever (42.9 %) were the most common symptoms. The overall microbiological and histological detection rates were 70.0 % and 38.6 %, respectively. The non-ascite samples yielded a higher microbiological confirmation rate (63.6 %) than the total samples (40.8 %). Diagnosis was confirmed histologically in 18 patients (69.2 %). Forty-five cases (64.3 %) were clinically diagnosed. Invasive procedures such as surgery (6/7), percutaneous biopsy (7/7) and endoscopy in lymph node TB (4/5) had high confirmation rates. the diagnosis of abdominal TB should be reached by a combination of clinical, laboratory, radiological, microbiological and pathological findings.

Meta-analysis of diagnostic accuracy of nucleic acid amplification tests for abdominal tuberculosis: A protocol.

BackgroundAbdominal tuberculosis is a severe extrapulmonary tuberculosis, which can lead to serious complications. Early diagnosis and treatment are very important for the prognosis and the diagnosis of abdominal tuberculosis is still difficult. This study aims to evaluate the diagnostic accuracy of nucleic acid amplification tests (NAATs) for abdominal tuberculosis using meta-analysis method.MethodsWe will search PubMed, the Cochrane Library, Embase, China National Knowledge Infrastructure, and the Wanfang database for studies evaluating the diagnostic accuracy of NAATs for abdominal tuberculosis until May 2020. We will include a systematic review and meta-analysis that evaluated the accuracy of NAATs for abdominal tuberculosis. Any types of study design with full text will be sought and included. The risk of bias will be assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. Stata version 15.0 with the midas command packages will be used to carry out meta-analyses.ResultsThe results will provide clinical evidence for diagnostic accuracy of NAATs for abdominal tuberculosis, and this systematic review and meta-analysis will be submitted to a peer-reviewed journal for publication.ConclusionThis overview will provide evidence of NAATs for diagnosis of abdominal tuberculosis.Systematic review registrationINPLASY202060030.

What is the accuracy of abdominal ultrasound (US) for the diagnosis of abdominal tuberculosis (TB) among people with HIV?

What is the accuracy of abdominal ultrasound (US) for the diagnosis of abdominal tuberculosis (TB) among people with HIV?

A prospective study of clinical presentation &amp; surgical management of abdominal tuberculosis at BMC, Sagar

Abdominal tuberculosis is an increasingly common disease that poses diagnostic challenge, as the nonspecific features of the disease which may lead to diagnostic delays and development of complications. This condition is regarded as a great mimicker of other abdominal pathology. A high index of suspicion is an important factor in early diagnosis. Abdominal involvement may occur in the gastrointestinal tract, peritoneum, lymphnodes or solid viscera. Various investigative methods have been used to aid in the diagnosis of abdominal tuberculosis. Early diagnosis and initiation of antituberculous therapy and surgical treatment are essential to prevent morbidity and mortality. Most of the patients respond very well to standard antitubercular therapy and surgery is required in some cases. Imaging plays an important role in diagnosis of abdominal tuberculosis because early recognition of this condition is important. Abdominal tuberculosis constitutes a chief public health setback, presents a diagnostic challenge requiring a high index of clinical suspicion. Young age at presentation, delayed presentation, poverty & high morbidity & mortality are among the hallmarks of the disease in this region. These challenges need to be addressed in order to deliver optimal care for these patients. Early diagnosis, early antituberculous therapy & surgical treatment of the related complications are important for survival.

Role of polymerase chain reaction of ascitic fluid and its correlation with adenosine deaminase levels in the diagnosis of abdominal tuberculosis

Background: It is still difficult to diagnose tuberculosis as a source of abdominal pain. Due to the lack of non-invasive diagnostic testing, the diagnosis remains a problem. Determining the role of polymerase chain reaction (PCR) in ascitic fluid in the diagnosis of abdominal tuberculosis, we can conclude whether it is sensitive/specific or not and further its use in the diagnosis of abdominal tuberculosis. Objective: The objective of the study was to determine the role of PCR in ascitic fluid in the diagnosis of abdominal tuberculosis and also to correlate the ADA levels of ascitic fluid with the PCR report. Materials and Methods: This prospective comparative study includes 41 clinically suspected abdominal tuberculosis patients (age range 15–65 years) over a period of 2 years. A detailed history, clinical evaluation, and relevant investigations, including radiology, were done in all patients. Bacteriological or histological approaches had to support the diagnosis of abdominal tuberculosis, and PCR was also tested for Mycobacterium tuberculosis in ascitic fluid. Results: The mean age of patients was 31.71±12.32 years with male:female ratio was 1.4:1. PCR was positive in 24 (58.8%) cases. A receiver operating characteristic curve showed that a cutoff value of 35.3 IU/L (AUC 0.998, P < 0.001) for the ADA level produced the best results as a diagnostic test for abdominal tuberculosis, yielding the following parameter values: Sensitivity 100%, specificity 94.1%, positive predictive value 96%, negative predictive value 100%, and diagnostic accuracy 97.56%. ADA values were significantly elevated during abdominal tuberculosis, indicating that ADA can still be a valuable diagnostic tool. Conclusion: Our findings indicate that ascitic fluid PCR is a safe tool for diagnosing it and should be tried at least before surgical intervention.

A diagnostic approach for differentiating abdominal tuberculosis from ovarian malignancy: a case series and literature review

BackgroundAbdominal tuberculosis is an uncommon variant of extrapulmonary tuberculosis. It accounts for 3.5% of extrapulmonary tuberculosis. Diagnosis of abdominal tuberculosis is still a challenge due to its non-specific symptoms. Abdominal tuberculosis and ovarian cancer may show similar symptoms, laboratory and imaging features. The goal of our report is to emphasize for the need of a diagnostic approach based on clinical manifestations, laboratory, imaging findings, and additional tests for considering a diagnosis of abdominal tuberculosis rather than ovarian cancer.Case presentationWe report 3 cases of abdominal tuberculosis in our Onco-gynaecology Division, Department of Obstetrics and Gynaecology, Sardjito Hospital, Yogyakarta, Indonesia in 2018 which were previously diagnosed as ovarian malignancy and managed surgically. All of our patients experienced abdominal pain and enlargement but only two of them had significant weight loss. The general symptoms were typically found in onco-gynaecology patients, especially in those with ovarian malignancy. Ultrasound examination showed multilocular masses, 2 of them with solid parts and ascites. Cancer antigen 125 (CA-125) levels were found increasing in those three patients. All of them were treated surgically and diagnosis of abdominal tuberculosis was established through the histopathological result of tissue biopsy. Based on our cases and literature, we consider the need of a diagnostic approach to differentiate abdominal tuberculosis from ovarian malignancy, an attempt to avoid unnecessary invasive procedures that put burden risk for the patients.ConclusionMinimally invasive tests to establish the diagnosis of abdominal tuberculosis should be optimized to reduce the burden risk of laparotomy. Careful diagnostic steps should be followed to avoid wrong diagnosis.

Difficulties and mistakes in the diagnosis of abdominal tuberculosis in the practice of the general practitioner

Identify clinical features and possibilities of timely AT diagnosis. Medical reports of 116 AT patients. The results of clinical, microbiological, immunological, radiological, endoscopic and morphological studies were analyzed. AT proceeded under the mask of ulcerative colitis and Crohn's disease (26.3%), alcoholic and biliary hepatitis (11.8%), lymphoproliferative and oncological diseases (61.8%), often generalized against the background of HIV-infection. The duration of the diagnostic search for disease verification exceeded 3 months due to incorrect (erroneous) interpretation of intoxication (26.3%) and radiological pattern in the lungs (23.7%), non - application and late application of laparoscopy (39.5%). When diagnosing AT, it is necessary to consider the peculiarities of its clinic and to conduct timely laparoscopy.

150 Abdominal Tuberculosis in the 21st Century in Peru: A Description of 22 Cases

INTRODUCTION: The diagnosis of abdominal tuberculosis (AT) remains complicated, although it's a common pathology in developing countries. A high degree of clinical suspicion is always needed in order to ensure its rapid detection. We aimed to describe and analyze the epidemiological, clinical and radiological features of patients diagnosed with abdominal tuberculosis: tuberculous lymphadenopathy, gastrointestinal, visceral and peritoneal tuberculosis (TB). METHODS: A prospective study was conducted between 2015 and 2016 and patients diagnosed with AT based on clinical, endoscopic and histopathologic features were collected. The clinical, epidemiological and radiological features were described by frequencies and percentages and then analyzed in Stata 12 to evaluate the associations between them. RESULTS: A total of 22 patients were included: 17 males (77%) with a mean age of 38.6 years. Twelve patients (55%) had only one type of AT and 10 patients (45%) had more than one. The most common diagnosis was gastrointestinal TB (14 cases, 64%), followed by peritoneal TB (10 cases, 45%), tuberculous lymphadenopathy (8 cases, 36%) and visceral TB (2 cases, 9%). The former showed 6 presentations: ileocecal (8 cases, 57%), colorectal (7 cases, 50%), duodenal (3 cases, 21%), gastric (2 cases, 14%), esophageal (1 case, 7%) and jejunal (1 case, 7%). The most important antecedents were HIV infection (11 cases, 52%), TB contact (9 cases, 43%) and pulmonary TB and alcoholism (7 cases, 33% each one). The most common symptoms were abdominal pain and weight loss (19 cases, 90% each one), anorexia (17 cases, 81%), fever (15 cases, 71%), nocturnal sweating (13 cases, 62%), chronic diarrhea (12 cases, 57%), cough (11 cases, 52%) and abdominal distension (11 cases, 52%). The physical findings were ascites (8 cases, 38%) and hepatosplenomegaly (5 cases, 24%), and the principal complication was lower gastrointestinal bleeding (5 cases, 24%). Radiological findings consistent with pulmonary tuberculosis were also common (13 cases, 62%). Only abdominal distention and ascites showed statistical association with peritoneal tuberculosis (Fisher's exact = 0.0001 and 0.008 respectively). CONCLUSION: Abdominal pain, B symptoms and chronic diarrhea are the most important manifestations of AT. Hence attention must be paid in patients with this symptoms, especially if they are immunocompromised. In these subjects abdominal distension and ascites seem to suggest the diagnosis of peritoneal TB.

Diagnostic accuracy of CBNAAT (Gene-Xpert) Vs liquid culture in clinically diagnosed presumptive childhood tuberculosis admitted in Pt. J.N.M. Medical College &amp; Dr. Bhim Rao Ambedkar Memorial Hospital, Raipur (C.G.)

Background: Paediatric tuberculosis comprises 10% of all tuberculosis in developing countries. Smear microscopy is diagnostic for Pulmonary TB whereas for extra-pulmonary TB, CBNAAT (Gene-Xpert) and liquid-culture are available choices. Objectives: To establish the comparative diagnostic efficacy of CBNAAT and Liquid-culture in clinically presumptive childhood Tuberculosis. Outcome: Assess sensitivity and specificity of CBNAAT Vs Liquid-culture in clinically diagnosed presumptive childhood tuberculosis. Material &amp; Method: After approval from institutional ethical committee this Cross-sectional study was performed in department of paediatrics Pt. J. N. M. Medical College, Raipur C.G. Total 97 paediatric presumptive TB cases were enrolled for systematic screening from June-2017 to July-2018. Samples were collected and analysed by CBNAAT and liquid-culture. Data for Diagnostic efficacy of both techniques were analysed with appropriate statistical method. Results: Among study subject group 41.2% belongs to 11-15 age-group and 53.6% were female. Majority of them belongs to joint family (81.4%) and low-socioeconomic (85.6%) status. Among 97 presumptive cases CBNAAT was positive in 24.7% whereas liquid-culture was positive in 22.7%. CBNNAT has sensitivity (100%) and specificity (98.61%) when compared with liquid-culture as gold-standard. It has 95.65% positive and 100% negative predictive values. CBNAAT had 100% of sensitivity and specificity in diagnosis of abdominal-tuberculosis and TB-meningitis. In Pulmonary-TB diagnosis its specificity reduced to 98%. Conclusion: CBNAAT is equally efficacious diagnostic tool to diagnose clinically presumptive TB cases and it should be used in public health system for early diagnosis of paediatric tuberculosis.

Isolated gastric varices secondary to abdominal tuberculosis mimicking lymphoma: a case report

BackgroundAbdominal tuberculosis (TB) rarely presents with abdominal masses and rarely causes isolated gastric varices.Case presentationWe report a case of isolated gastric varices secondary to abdominal TB mimicking lymphoma. A 42-year-old woman without any history of liver disease presented with melena and mild abdominal pain. Upon admission to the hospital, laboratory investigations revealed a hemoglobin level of 76 g/L. Gastroduodenoscopic examination showed isolated gastric fundal varices with red color signs. Abdominal contrast-enhanced computed tomography (CECT) revealed non-enhanced masses of soft-tissue density in the lesser omental and the retropancreatic areas, multiple para-aortic lymph nodes, and multiple small hypodense splenic lesions. Positron emission tomography-CT showed hypermetabolic [F-18]2-fluoro-2-deoxyglucose activity involving multiple regional lymph nodes and the bone marrow, suggestive of lymphoma. Bone marrow biopsy revealed no abnormality. Histopathological examination of a CT-guided biopsy specimen showed granulomatous inflammation with necrosis and microorganisms that stained positive with acid-fast stains. Abdominal CECT showed a decrease in the size of the lesser omental and peripancreatic masses, as well as the para-aortic lymph nodes after 4-month anti-TB therapy.ConclusionsTB should be considered among the differential diagnoses in patients with abdominal masses, isolated gastric varices, and regional lymphadenopathy. Prompt and definitive diagnosis of abdominal TB requires a coordinated approach involving laboratory tests, radiological examination, and invasive procedures for optimal decision making and management.

Common and uncommon imaging features of abdominal tuberculosis.

Despite the advances in the medical care, tuberculosis (TB) still remains an important health problem. This is particularly relevant to the developing countries as well as the immunocompromised population in the developed world. Multidrug resistance poses another challenge and may be responsible for increasing incidence of TB, to some extent. The respiratory system is the most commonly involved, although any organ system may be affected. Abdominal involvement occurs in 11-12% of the patients with extrapulmonary TB. The clinical features of abdominal TB are nonspecific. Imaging plays an important role in the diagnosis of abdominal TB. Although a few imaging features strongly favour the possibility of TB, abdominal TB is a greater masquerader. In this review, we highlight the entire spectrum of the manifestations of abdominal tuberculosis (excluding the genitourinary involvement) with an emphasis on imaging findings.