Learning objectives
To identify and describe the various imaging features of abdominal tuberculosis on computed tomography.
Review the imaging of complications secondary to abdominal tuberculosis which can manifest as acute abdomen.
Background
Tuberculosis is a global health problem causing significant morbidity and mortality.
According to the Global tuberculosis report by WHO in 2017,
the annual incidence of tuberculosis was 10.4 million and about 1.7 million people died from the disease in 2016.[1] Tuberculosis also became one of the top ten causes of morbidity worldwide.[1] About 64% of the cases were reported from the seven countries,
with India leading the count,
followed by Indonesia,
China,
Philippines,
Pakistan,
Nigeria,
and South Africa.[1]In the last few decades we have seen...
Findings and procedure details
We will be discussing the myriad manifestations of tuberculosis on computed tomography according to the systems involved such as the peritoneum,
lymphatic,
gastrointestinal,
visceral and genitourinary systems.
[3,5,6,7]
Peritoneum
Involvement of the peritoneum which includes the peritoneal cavity,
mesentery and the omentum,
is the most common presentation of abdominal tuberculosis.[2,7] It results from hematogeneous spread of the disease or can be secondary to rupture of mesenteric lymph nodes,
gastrointestinal dissemination or tubercular salpingitis.[7] Tubercular peritonitis is categorized into three types - dry,
wet and fibrinous.[5,7]....
Conclusion
Abdominal tuberculosis is a great masquerader due to its varied clinical and imaging features.
Hence it is imperative for the radiologist to be aware of the typical and atypical manifestations of abdominal tuberculosis and its devastating complications for its timely diagnosis.
Personal information
Dr.
Harsha Jeswani,
Second year resident,
Dr.
DY Patil Hospital,
Navi Mumbai,
Maharashtra,
India.
References
1.Global tuberculosis report 2017,
WHO http://apps.who.int/iris/bitstream/10665/259366/1/9789241565516-eng.pdf?ua=1
2.
Sinan T,
Sheikh M,
Ramadan S,
Sahwney S,
Behbehani A.
CT features in abdominal tuberculosis: 20 years experience.BMC Medical Imaging.
2002;2:3.
doi:10.1186/1471-2342-2-3.
3.Sharma R,
Madhusudhan KS,
Ahuja V.
Intestinal tuberculosis versus crohn's disease: Clinical and radiological recommendations.
Indian J Radiol Imaging 2016;26:161-72
4.Kapoor VK.
Abdominal tuberculosis.Postgraduate Medical Journal.
1998;74(874):459-467.
5.Debi U,
Ravisankar V,
Prasad KK,
Sinha SK,
Sharma AK.
Abdominal tuberculosis of the gastrointestinal tract: Revisited.World Journal of Gastroenterology : WJG.
2014;20(40):14831-14840.
doi:10.3748/wjg.v20.i40.14831.
6.Awasthi S,
Saxena M,
Ahmad...