Common and uncommon imaging features of abdominal tuberculosis

Abstract

Summary Despite the advances in the medical care, tuberculosis (TB) still remains an important health problem. This is particularly relevant to the developing countries as well as the immunocompromised population in the developed world. Multidrug resistance poses another challenge and may be responsible for increasing incidence of TB, to some extent. The respiratory system is the most commonly involved, although any organ system may be affected. Abdominal involvement occurs in 11–12% of the patients with extrapulmonary TB. The clinical features of abdominal TB are nonspecific. Imaging plays an important role in the diagnosis of abdominal TB. Although a few imaging features strongly favour the possibility of TB, abdominal TB is a greater masquerader. In this review, we highlight the entire spectrum of the manifestations of abdominal tuberculosis (excluding the genitourinary involvement) with an emphasis on imaging findings.

Tuberculosis Presenting as Hepatic and Splenic Microabscesses

“…TB can occur in virtually any abdominal structure ( Table 2) [4,5]. The incidence of abdominal TB is estimated to be 11% of the total load of extra-pulmonary TB [6]. It occurs by hematogenous or contiguous spread from other organs, or by reactivation of latent TB [7].…”

TB or not TB: A comprehensive review of imaging manifestations of abdominal tuberculosis and its mimics

“…Late stages can show eccentric mural thickening involving the medial cecal wall and the valve, with regional lymphadenopathy and inflammatory changes. 37 These findings are easily demonstrated on CT imaging (Fig. 4).…”

“…3,8 An abundance of lymphoid tissue and an increased rate of absorption may predispose this site for TB involvement. 37 The involvement of the rest of the small bowel is infrequent and usually occurs together with peritonitis. 24 Clinical symptoms include colicky abdominal pain, weight loss and anemia, and complications due to intestinal obstruction, perforation and hemorrhage may also occur.…”

“…5). 37 The radiological differential for the appearance of jejunal and ileal TB includes infectious causes such as amebiasis and infection caused by Salmonella and Yersinia; inflammatory causes such as Crohn's disease and ulcerative colitis causing backwash ileitis, and malignancy such as primary cecal malignancy. 19,38,39…”

Hepatic Infections: A Comprehensive Imaging Review

“…Unlike abscesses, neoplasms seldom show the layered appearance, segmental enhancement, Hepatobiliary tuberculosis may present with hepatic, pancreatic, gallbladder, or biliary involvement. 14 Hepatic tuberculosis may present in two forms. Hematogenous dissemination of tuberculosis to the liver presents as its micronodular form with tiny (<2 mm) nodules that calcify on healing.…”