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Learning Objectives
1. To identify usual and unusual radiologic features of tuberculosis (TB) affecting various organs in the abdomen. 2. To describe the differential diagnosis and appropriate imaging work-up for abdominal TB.
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Background
1. Abdomen is the most common focus of extrapulmonary tuberculosis (TB). TB can affect various organs in the abdomen. Gastrointestinal tract :ileocecum and colon, peritoneum, mesentery, and omentum, liver, lymph nodes, adrenals and genitourinary tract,. 2. There are typical and atypical radiologic (radiograph, barium studies, CT, or MR) findings of abdominal TB. 3. Other pathologic conditions such as cancer, lymphoma or inflammation can mimic abdominal TB radiologically.
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Imaging Findings/Procedure Details
Tuberculous lymphadenopathy • Most common manifestation of abdominal tuberculosis • Usually associated with GI tract, peritoneal or solid organ involvement • Can be the only sign of the disease • Commonly involved sites are mesenteric root, celiac axis, porta hepatis and peripancreatic areas • Increased number of normal size nodes, scattered mildly enlarged nodes, localized clusters of enlarged nodes and large conglomerated masses • Caseation and liquefaction at the center of the enlarged...
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Conclusion
Although abdominal TB is usually secondary to pulmonary TB, radiologic evaluation often shows no evidence of lung disease. Therefore, it is important to know usual and unusual imaging findings of TB in various abdominal organs and how TB can mimic avariety of other disease entities.
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References
1. Burrill J, Williams CJ, Bain G, Conder G, Hine A, Misra R. Tuberculosis: A Radiological Review. Radiographics 2007;27:1255-1272 2. Pereira JM, Madureira AJ, Vieira A, Ramos I. Abdominal Tuberculosis: Imaging features. EJR 2005;55:173-180 3. Gibson S, Puckett ML, Shelly ME, Renal Tuberculosis. RadioGraphics 2004;24:251-256 4. Kim SH, Kim SH, Yang DM, Kim KA. Unusual Causes of Tubo-ovarian Abscess: CT and MR Imaging Findings. Radiographics 2004;24:1575-1589
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Author Information
Kyeong Ah Kim MD, PhD Professor, Department of Radiology Korea University Guro Hospital 148 Gurodong-ro, Guro-gu, Seoul, 152-703, Korea Office: 82-2-2626-1338 Fax: 82-2-863-9282 Mobile: 82-10-8832-0846 E-mail: kahkim@korea.ac.kr