Pediatric Abdominal Tuberculosis With Calcified Intra-abdominal Lymph Nodes Identified by Point-of-Care Ultrasound

Area of Science:

• Pediatric Emergency Medicine
• Radiology
• Infectious Diseases

Background:

• Abdominal tuberculosis is a frequent extrapulmonary manifestation of tuberculosis, often challenging to diagnose due to non-specific symptoms.
• Limited availability of specialized diagnostic expertise at the point of care can further complicate diagnosis in endemic areas.
• Point-of-care ultrasound (POCUS) is increasingly adopted in emergency departments for rapid diagnostic assessments.

Observation:

• A case is presented of a pediatric patient in the emergency department experiencing acute abdominal pain.
• Point-of-care ultrasound (POCUS) was utilized to evaluate the patient's abdominal condition.

Findings:

• POCUS revealed key indicators suggestive of abdominal tuberculosis, including intra-abdominal lymphadenopathy, ascites, mesenteric thickening, ileocecal thickening, and splenic microabscesses.
• These ultrasound findings facilitated an expedited bedside diagnosis of abdominal tuberculosis.

Implications:

• In specific clinical contexts, the combination of ultrasound findings like lymphadenopathy, ascites, and bowel thickening strongly suggests abdominal tuberculosis.
• POCUS can serve as a valuable tool for the rapid, bedside diagnosis of abdominal tuberculosis in the emergency department, complementing traditional imaging modalities.
• This case highlights the utility of POCUS in resource-limited settings or when immediate diagnostic clarification is needed for suspected abdominal tuberculosis.