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Objective: To describe CT findings of abdominal tuberculosis (TB) because CT has the ability to demonstrate changes in the abdomen and is increasingly used for primary evaluation of abdominal conditions.
Methods: The abdominal CT images of 33 patients with proven abdominal TB in Siriraj Hospital from January 2005 to December 2009 were retrospectively reviewed. The CT findings of ascites, peritoneum, lymph node, gastrointestinal and visceral organ involvement were evaluated.
Results: The peritoneal and lymph node involvement were the most common features (78.8% of each finding). Peritonitis with ascites (wet type) was more common than dry type. Most of the patients with lymph node involvement had multiple groups (96.2%) and the most common location was mesenteric region. The gastrointestinal tract involvement was likely to be the combination of large bowel and small bowel diseases and the most common feature was bowel wall thickening (88.2%). The solid organ involvement was found about 20.4% which was always the part of multiple organs involvement or dissemi- nated disease. The lymph node involvement in the immunocompromised group was statistically significantly different when compared with the non-immunocompromised group. (p 0.001)
Conclusion: CT scan is a reliable imaging modality to demonstrate abnormality in the abdominal cavity. The common features in the patients with abdominal tuberculosis include the combination of peritoneal, lymph nodes and multiple organs involvement. Diagnosis of abdominal tuberculosis is sometimes difficult to rely on CT features, so interpretation of images with the clinical and laboratory data could be a valuable tool in the diagnosis of abdominal tuberculosis, especially in patients with non-specific abdominal symptoms. Early and accurate diagnosis leads to an effective therapy and good prognosis with decrease of mortality rates.
Keywords: Computed tomography, abdominal tuberculosis
Siriraj Med J 2014;66:56-60
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