Imaging of gastrointestinal and abdominal tuberculosis

Abstract

This article discusses the range of manifestations of tuberculosis (TB) of the abdomen, including involvement of the gastrointestinal tract, the peritoneum, mesentery, omentum, abdominal lymph nodes, solid abdominal organs, the genital system and the abdominal aorta. Abdominal TB is a diagnostic challenge, particularly when pulmonary TB is absent. It may mimic many other abdominal diseases, both clinically and radiologically. An early correct diagnosis, however, is important in order to ensure proper treatment and a favorable outcome. Modern imaging is a cornerstone in the early diagnosis of abdominal TB and may prevent unnecessary morbidity and mortality. Generally, CT appears to be the imaging modality of choice in the detection and assessment of abdominal tuberculosis, other than gastrointestinal TB. Barium studies remain superior for demonstrating mucosal intestinal lesions. Ultrasound may be used for follow-up to monitor therapy response. The diagnosis of abdominal TB should be considered if suggestive imaging findings are found in patients with a high index of suspicion.

Disseminated tuberculosis diagnosed first as leptospirosis in immunocompetent patient

“…These unspecific features were also found together with specific tuberculosis lesions. 6,8 Liver biopsy of this patient confirmed the diagnosis of hepatic tuberculosis which were shown by caseous necrosis, granuloma formation, and positive AFB staining.…”

“…Similarly, even guided percutaneous liver biopsy and laparatomy were successfully performed in isolated liver TB, diagnosis could still be missed. 8 With the fact of so many challenges in making definite diagnosis of hepatic tuberculosis, this patient was successfully diagnosed and treated.…”

“…After the disease worsened, calcification could occur and seen by imaging. 3,6,8 This might explain the bright liver and no tubercle seen in ultrasound while CT scan of the abdomen revealed hepatomegaly and severe fatty liver. Therefore needle biopsy is very important in liver tuberculosis diagnosis.…”

Evaluation of Forty-Nine Patients with Abdominal Tuberculosis

“…The other sites such as stomach, duodenum, colon, liver and spleen are extremely rare. Hepatic TB occurs as the following types: Micronodular, macronodular, mixed, and isolated tubercular abscess [12]. Splenic tuberculosis may manifest as isolated splenomegaly, micronodular, or macronodular form.…”

Computed Tomographic Colonography Findings in Ileocecal Tuberculosis

“…An imaging diagnosis of intestinal tuberculosis is usually based on abdominal CT, barium enema, or ultrasound imaging [1,2]. Recently, CT enterography has been reported to be useful for the differential diagnosis between intestinal tuberculosis and Crohn's disease [3,4].…”