Type:
Educational Exhibit
Keywords:
Gastrointestinal tract
Authors:
Y. H. Lee, H. S. Shin, E. Kang; Iksan/KR
DOI:
10.1594/ecr2010/C-1637
Background
Although tuberculosis is an endemic disease of developing countries, the global incidence of tuberculosis has increased and the number of the cases of extrapulmonary tuberculosis has also increased. Abdominal tuberculosis (Tbc) is an uncommon condition, but there has been a resurgence of the disease, becoming an endemic disease in most of the developing countries [1], largely due to the AIDS epidemic. So the interest in abdominal tuberculosis is increased with developing variable diagnostic or therapeutic modalities. However the diagnosis of abdominal tuberculosis still remains a diagnostic challenge. The presence of thoracic tuberculosis may be suggestive of associated abdominal TB, however only 15% of patients with abdominal TB have evidence of pulmonary disease [2].
With widespread use of MDCT, we can more easily understand the disease processes and various imaging features of abdominal tuberculosis. The radiologist should be familiar with various CT findings of abdominal tuberculosis that can mimic other non-tuberculous abdominal diseases.
The postulated mechanisms by which the tubercule bacilli reach the abdominal organ are: (i) hematogenous spread from the primary lung focus in childhood, with later reactivation; (ii) ingestion of bacilli in sputum from active pulmonary focus; (iii) direct spread from adjacent organs; and (iv) and through lymph channels from infected nodes. [3]
The concept of "abdominal tuberculosis" in this review refers to solid abdominal organs, gastrointestinal (GI) tract, peritoneum and its reflections, abdominal lymphatic system, genitourinary system and as they are subject to varying degrees of involvement alone or in combination.