Learning objectives
Tuberculosis is a life-threatening disease that can affect any organ or system.
Its prevalence is increasing in both immunocompetent and immunocompromised patients in recent years.
Tuberculosis has a great variety of clinical and radiologic features and has a known propensity to dissemination from its primary site,
usually the lung.
Diagnosis of extra-pulmonary tuberculosis is often difficult as it can mimic numerous other disease entities.
Thus,
it is important to be familiar with its various radiologic features.
In this poster we will illustrate and describe imaging...
Background
Although manifestations of tuberculosis are usually limited to the chest,
the disease can affect any organ.
Classically,
pulmonary tuberculosis is divided in primary and post-primary infection.
However there is considerable overlap in the radiological manifestations of these two entities.
Post-primary tuberculosis results from reactivation of a previous dormant primary infection.
It is almost exclusively a disease of adolescence and adulthood.
Post-primary tuberculosis may appear as parenchymal,
airway or pleural disease as well as it can affect other organs outside the thorax.
Abdominal organs are usually...
Imaging findings OR Procedure details
There are no pathognomonic features of abdominal tuberculosis in radiological examinations and therefore,
microbiological or histological proof should always be obtained by percutaneous aspiration or biopsy.
However,
imaging studies may suggest the diagnosis,
especially in those patients whit multi-organ involvement.
The combination of multiple suggestive imaging features in the appropriate clinical context may be the clue to the diagnosis.
Imaging findings in AIDS patients are usually indistinguishable from those seen in non-AIDS patients.
Although tuberculosis can affect any organ in the abdomen,
emphasis is placed...
Conclusion
Determining the correct diagnosis of abdominal tuberculosis remains challenging and requires a high suspicion index.
The clinical and imaging features are unspecific and may mimic many different diseases.
Even though,
obtaining a definite diagnosis is crucial,
as untreated disease has a high mortality rate.
Although there are no pathognomonic imaging findings,
features that suggest abdominal tuberculosis include thickening of the terminal ileum,
cecum and ileocecal valve,
smooth peritoneal thickening,
misty mesentery with necrotic enlarged lymph nodes and free or loculated ascites with debris and septa....
References
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Harisinghani M,
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Tuberculosis from head to toe.
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Pereira JM,
Madureira AJ,
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Abdominal tuberculosis: imaging features.
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Vanhoenacker FM,
De Backer AI,
Op de BB,
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Imaging of gastrointestinal and abdominal tuberculosis.
Eur Radiol.
2004; 14,
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Engin G,
Acunas B,
Acunaş G,
et al.
Imaging of extrapulmonary tuberculosis.
Radiographics 2000; 20(2):471-88
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Akhan O,
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Imaging of abdominal tuberculosis.
Eur Radiol.
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