Aims and objectives
To differentiate peritoneal tuberculosis from carcinomatosis on Computed Tomography scan of abdomen taking omental biopsy as the gold standard.
Methods and materials
This retrospective diagnostic accuracy review of cases was cnducted at Aga Khan university hospital Karachi Pakistan,
and comprised patient's medical record files from Feburary 2007 to Feburary 2016.
CT scan findings were compared with diagnosis made on the basis of histopathology.
Multiple logistics regression analysis was done and sensitivity and specificity were tested through Pearson chi square test.
Results
A total of 102 patients were identified with abdominal diseases and 98(96%) were included after applying the exclusion criteria.
Of those included,
62(63.2%) were found to be cases of disseminated TB and 36(36.7%) were diagnosed as malignant on histopathology.
Comparison of CT findings with histologic diagnosis was done (Table-1).
When comparing CT scan findings to histopathology,
4 findings on a CT scan showed statistical significance to diagnose TB over carcinomatosis; smooth thickening of the peritoneum,
abdominal mass,
lymph node necrosis and high density ascitic fluid....
Conclusion
No single finding on a CT scan was enough to diagnose peritoneal TB.
A combination of findings could reliably distinguish between peritoneal TB and carcinomatosis.
A high degree of suspicion is required,
especially in highrisk populations.
Personal information
Farah Naz,
Consultant Radiologist Cancer Foundation Hospital,
Karachi-Pakistan.
This study was done in Aga Khan University Hospital where I was previously employed.
email:
[email protected] Phone: +93453286621
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