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Case Reports
. 2020 Nov 18;16(1):197-200.
doi: 10.1016/j.radcr.2020.11.005. eCollection 2021 Jan.

A rare case of abdominal tuberculosis

Thom Drew  1 , Randall McGill  1
Affiliations
Case Reports

A rare case of abdominal tuberculosis

Thom Drew et al. Radiol Case Rep. .

Erratum in

Abstract

Abdominal tuberculosis (TB) is a rare condition in developed nations and can be challenging to diagnose. This report concerns a 45-year-old patient who presented with abdominal pain and fever and would undergo a lengthy hospital admission complicated by a previously undiagnosed HIV infection. Computed tomography imaging performed the day our patient presented to the emergency room revealed rather classic findings corresponding with abdominal tuberculosis However, diagnostic difficulty delayed the diagnosis and treatment. This case highlights radiologists' opportunity to raise clinical suspicion early in hospital care, especially in a rare disease process that can have poor outcomes.

Keywords: Abdominal; Extrapulmonary; HIV; Immunocompromised; Intestinal; Tuberculosis.

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Figures

Fig. 1 –
Fig. 1
Axial image from contrast-enhanced CT abdomen reveals an abnormally thickened wall of the cecum (dark blue arrow) and ascending colon (light blue arrow) with pericolonic infiltration of the mesenteric fat. (Color version is available online.)
Fig. 2 –
Fig. 2
Axial image from contrast-enhanced CT abdomen reveals hypodense adenopathy in the porta hepatis (dark blue arrow) and retroperitoneum (light blue arrow). (Color version is available online.)
Fig. 3 –
Fig. 3
Coronal image from contrast-enhanced CT abdomen reveals normal ileum (dark blue arrow) vs. abnormal ileum (light blue arrow) as well as the ileocecal valve (light blue dotted arrow). Hypodense adenopathy (light blue stars) in the retroperitoneum and porta hepatis can also be appreciated.
Fig 4 –
Fig 4
Axial image from CTA chest revealed bilateral subcentimeter pulmonary nodules with a random distribution, worsening effusions (dark blue arrows), and atelectasis.
Fig – 5
Fig – 5
EGD demonstrates a mass-like area in the duodenal bulb with a cratered ulcer (dark blue arrow) and fistula advancing into the peritoneum.
Fig 6 –
Fig. 6
Colonoscopy revealed a patulous ileocecal valve (dark blue arrow).
Fig 7 –
Fig. 7
Colonoscopy revealed a localized area of severely ulcerated mucosa (dark blue arrow) found in the cecum and immediately adjacent to the ileocecal valve.
See this image and copyright information in PMC

References

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