Abstract
Four boys with abdominal tuberculosis, one of whom had acquired immunodeficiency syndrome, are presented. Abdominal imaging findings on plain radiography, ultrasonography, computed tomography, and gastrointestinal contrast studies included tuberculous peritonitis and ascites in all patients, tuberculous adenopathy in two, gastrointestinal tuberculosis in two, and omental tuberculosis in two. The radiographic features particularly characteristic of abdominal tuberculosis were: (1) low attenuating adenopathy with rim enhancement, (2) omental or ileocecal inflammatory mass, (3) high density ascites, and (4) gastrointestinal enteritis involving the ileocecal region. All patients had acidfast bacilli identified in cultures of bodily fluids and/or pathologic specimens and three patients had cultures positive forMycobacterium tuberculosis. The patient with a negative culture had a positive PPD skin test and a surgical specimen showing caseating granulomata and acid-fast bacilli in the omentum. The radiologist must maintain a high degree of suspicion for abdominal tuberculosis particularly in normal or immunosuppressed children with acquired immunodeficiency syndrome. Fine needle aspiration and biopsy of abdominal adenopathy, inflammatory mass or ascites may be necessary for diagnosis.
Similar content being viewed by others
References
Thoeni RF, Margulis AR (1979) Gastrointestinal tuberculosis. Semin Roentgenol 14: 283–294
Denath FM (1990) Abdominal tuberculosis in children: CT findings. Gastrointest Radiol 15: 303–306
Epstein BM, Mann JH (1982) CT of abdominal tuberculosis. AJR 139: 861–866
Bhansali SK (1977) Abdominal tuberculosis. Experience with 300 cases. Am J Gastroenterol 67: 324–337.
Dwiwedi BD (1982) Abdominal tuberculosis in children. Prog Pediatr Surg 15: 169–171
Madhok P, Kapur VK (1982) Abdominal tuberculosis in children. Prog Pediatr Surg 15: 173–180
Mitra SK, Yadav K, Mehta S, Kumar L, Pathak IC (1978) Abdominal tuberculosis in children. Indian J Surg 40: 96–100
Nagi B, Duggal R, Gupta R, Mehta S (1987) Tuberculous peritonitis in children. Pediatr Radiol 17: 282–284
al-Hadeedi S, Walia HS, al-Sayer HM (1990) Abdominal tuberculosis. Can J Surg 33: 233–237
Chavalittamrong B, Talalak P (1982) Tuberculous peritonitis in children. Prog Pediatr Surg 15: 161–167.
Fraki O, Peltokallio P (1975) Intestinal and peritoneal tuberculosis: report of two cases. Dis Colon Rectum 18: 685–693
Pombo F, Rodriquez E, Mato J, Pere-Fontan J, Rivera E, Valvuena L (1992) Patterns of contrast enhancement of tuberculous lymph nodes demonstrated by computed tomography. Clin Radiol 46: 13–17
Brown JH, Berman JJ, Blickman JG, Chew FS (1993) Primary ileocecal tuberculosis. AJR 160: 278
Lee DH, Lim JH, Ko YT, Yoon Y (1991) Sonographic findings in tuberculous peritonitis of wet-ascitic type. Clin Radiol 44: 306–310
Hulnick DH, Megibow AJ, Naidich DP, Hilton S, Cho KC, Balthazar EJ (1985) Abdominal tuberculosis: CT evaluation. Radiology 157: 199–204
Zirinsky KZ, Auh YH, Kneeland JB, Rubenstein WA, Kazam E (1985) Computed tomography, sonography, and MR imaging of abdominal tuberculosis. J Comput Assist Tomogr 9: 961–963
Balthazar EJ, Gordon R, Hulnick D (1990) Ileocecal tuberculosis: CT and radiologic evaluation. AJR 154: 499–503
Dahlene DH, Stanley RJ, Koehler RE, Shin MS, Tisller JMA (1984) Abdominal tuberculosis: CT findings. J Comput Assist Tomogr 8: 443–445
Banerjee AK, Coltart DJ (1990) Abdominal tuberculosis mimicking lymphoma in a patient with sickle cell anaemia. Br J Clin Pract 44: 660–661
Perich J, Ayuso MC, Vilana R, Ayuso JR, Cardenal C, Mallofré C (1990) Disseminated lymphatic tuberculosis in acquired immunodeficiency syndrome: computed tomography findings. Can Assoc Radiol J 41: 353–357
Hanson RD, Hunter TB (1985) Tuberculous peritonitis: CT appearance. AJR 144: 931–932
Radin DR (1991) IntraabdominalMycobacterium tuberculosis vsMycobacterium avium-intracellulare infections in patients with AIDS: distinction based on CT findings. AJR 156: 487–491
Rosengart TK, Coppa GF (1990) AbdominalMycobacterium infections in immunocompromised patients. Am J Surg 159: 125–131
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ablin, D.S., Jain, K.A. & Azouz, E.M. Abdominal tuberculosis in children. Pediatr Radiol 24, 473–477 (1994). https://doi.org/10.1007/BF02015002
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02015002