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Intra-abdominal tuberculous peritonitis
G Schneider1, F Ahlhelm, P Hennes
1Department of Diagnostic Radiology, University Hospital, Homburg, Germany. ragsne@med-rz.uni-sb.de
Abstract:
We report the case of a 15-year-old boy suffering from progressive dyspnea on exertion and painful abdominal protrusion. Final diagnosis of intra-abdominal tuberculosis (TB), including lymphadenopathy and abdominal abscess formation, was made following elective laparotomy. This type of disease is a rare manifestation of extrapulmonary tuberculosis. The imaging findings in unenhanced and contrast-enhanced MRI and laparoscopic images are presented. Differential diagnosis of abdominal abscess formation and other fungal or bacteriological infections, as well as the imaging findings of this type of lesion, are discussed. This case demonstrates that atypical manifestation of TB may remain unrecognized; thus, awareness of this kind of manifestation of tuberculosis may prevent patients from being subjected to inappropriate therapies.
Insights
Intra-abdominal tuberculosis (TB) is a rare cause of abdominal abscesses and lymphadenopathy in adolescents. Early recognition of this atypical TB presentation is crucial to avoid misdiagnosis and ensure appropriate treatment.
Area of Science:
- Medical Imaging
- Infectious Diseases
- Abdominal Surgery
Background:
- Intra-abdominal tuberculosis (TB) is an uncommon form of extrapulmonary TB.
- A 15-year-old male presented with progressive dyspnea and abdominal protrusion.
Observation:
- A 15-year-old male presented with progressive dyspnea on exertion and abdominal pain/protrusion.
- Diagnostic laparotomy revealed intra-abdominal tuberculosis with lymphadenopathy and abscess formation.
Findings:
- Unenhanced and contrast-enhanced MRI demonstrated findings consistent with abdominal abscesses.
- Laparoscopic imaging provided further characterization of the intra-abdominal lesions.
- Differential diagnosis included fungal and bacterial infections, highlighting imaging challenges.
Implications:
- This case underscores the importance of considering atypical tuberculosis presentations.
- Awareness of intra-abdominal TB can prevent diagnostic delays and incorrect therapies.
- Radiological and clinical vigilance is essential for diagnosing rare forms of TB.