Learning objectives
This pictorial review will:Review the imaging features of abdominal TB across the range of modalities.Illustrate findings that will help diagnose the condition and differentiate it from common mimics such as malignancy, inflammatory bowel disease and other infections.
Background
Tuberculosis (TB) has re-emerged as a global public health emergency, largely due to the AIDS epidemic.Abdominal TB is usually due to mycobacterium tuberculosis or mycobacterium avium in the immunocompromised host.Thoracic TB may suggest associated abdominal TB, however only 15% with abdominal disease have evidence of pulmonary TB.TB can affect any organ and we present imaging features of solid viscera, ileocaecal, peritoneal and lymph node involvement.THE "GREAT MIMIC"Abdominal TB mimics many conditions both clinically and radiologically and can result in significant morbidity. Familiarity with the imaging...
Imaging findings OR Procedure details
TUBERCULOUS LYMPHADENOPATHY PATHOPHYSIOLOGY Most common manifestation of abdominal TB, seen in around 60% of patients and usually associated with GI tuberculosis.Routes of transmission include:Ingestion of infected materialHaematogenous spread Direct spread from adjacent infected organsThe usual pattern is peripancreatic and mesenteric lymph node group involvement with multiple groups involved at anyone time. IMAGING FEATURES Lymphadenopathy can be the only sign of disease especially in the periportal region.Around 50% have enlarged nodes with hypoattenuating centres. This is highly suggestive of, but not pathognomonic of tuberculous necrosis.Other patterns...
Conclusion
Abdominal tuberculosis is difficult to diagnose due to its varied presentation, and both the symptoms and imaging features can mimic several other important conditions.Although there are no pathognomonic imaging findings, several characteristic imaging features can be seen.A high index of suspicion and a recognition of the common imaging findings can lead to an early diagnosis and reduction in the long-term morbidity and mortality.We have presented the pathophysiology of abdominal TB and common imaging appearances. In addition we have detailed characteristic features which can aid in...
References
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