A REVIEW OF PATTERNS OF CT SCAN APPEARANCES OF ABDOMINAL TUBERCULOSIS

Abstract

Objectives: To assess role of CT in diagnostic workup of abdominal tuberculosis.

Methodology: In this descriptive study, through electronic database, out of7000 CT abdomens performed between January, 2002 to August, 2013, 30patients with suggestion of Abdominal TB based upon CT and clinical findingswere identified. Out of these 30 cases, twenty one patients were confirmed tohave abdominal TB based upon histopathological data and response to antituberculous treatment and were included in the study and the remaining 9patients were excluded from the study.

Results: Out of 21 confirmed abdominal TB cases, majority (n=13) were females.Peritoneal involvement was the most common feature seen in all 21(100%) patients. Smudgy pattern, with or without smooth marginal enhancement,was the most commonly seen pattern of peritoneal involvement. Wetperitonitis (peritonitis with ascites) was seen in 14 (66%) out of 21 patientswhile dry peritonitis was seen in 7 (34%) patients. Lymphadenopathy was thesecond most common feature seen in 13 (62%) out of 21 patients. Bowelinvolvement was demonstrated in 11(52%) patients. Ileocecal region was thecommonest site of bowel involvement seen in 7 of these 11 patients. Liverlesions were observed in 2 patients and splenic and pancreatic lesions wereidentified in 1 patient each.

Conclusion: Smudgy pattern of peritoneal involvement, enlarged necrotic abdominallymph nodes, high density ascites and ileocecal involvement are themost common abnormalities seen in patients of abdominal tuberculosis inour local population.