Imaging features of abdominal tuberculosis on multidetector CT and its mimics

  • Sripathi S
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Background: Abdominal tuberculosis is endemic in developing countries and its incidence is on an increase in the western world. The involvement of gastrointestinal tract is seen in 65-78% cases of abdominal tuberculosis with ileocaecal region being the commonest site followed by colon and jejunum. The disease can mimic various gastrointestinal disorders particularly inflammatory bowel disease, colonic malignancy or other gastro-intestinal infections. MDCT (Multidetector CT) because of multiplanar imaging plays an important role in diagnosis of abdominal tuberculosis due to excellent demonstration of changes in bowel, mesentery, lymph nodes, peritoneum, omentum and solid organs. Methods: This study was done in Dept. of Radio-diagnosis, Kasturba Medical College, Manipal between April - December 2011 where MDCT features of 23 patients with findings suspicious for Abdominal tuberculosis were evaluated. All patients underwent both plain and contrast enhanced CT (CECT). Patients with imaging features of genitourinary tuberculosis and those with HIV positive status were not included in the study. Results: Enhancing wall thickening involving ascending colon, caecum and ileo-caecal junction with adjacent lymph nodes was the most common finding seen in 8 cases. Peritoneal involvement in the form of ascites with enhancing and thickened parietal and visceral peritoneum was noted in 5 cases. Multiple strictures involving small bowel was the next most common finding in 3 cases. Lymph nodal involvement was seen in the form of mesenteric and retro-peritoneal lymphnodes with some of them showing caseation necrosis or calcific foci in 3 cases. Hepatic lesion which was proven to be tuberculosis on histopathology was seen in 1 case. There were 2 cases with thickened small bowel wall which were confirmed to be inflammatory bowel disease on histopathology and 1 case which showed ulcero-proliferative pattern which was confirmed to be malignant. Conclusion: There are variable imaging features of abdominal tuberculosis which are better demonstrated on MDCT. Although no single feature is diagnostic, a combination of imaging featureswhen correlated with clinical and laboratory data can help in clinching the diagnosis.




Sripathi, S. (2012). Imaging features of abdominal tuberculosis on multidetector CT and its mimics. International Journal of Infectious Diseases, 16, e296.

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