Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Sep 28, 2015; 7(9): 286-293
Published online Sep 28, 2015. doi: 10.4329/wjr.v7.i9.286
Intraperitoneal tuberculous abscess: Computed tomography features
Peng Dong, Jing-Jing Chen, Xi-Zhen Wang, Ya-Qin Wang
Peng Dong, Xi-Zhen Wang, Ya-Qin Wang, Medical Imaging Center, the Affiliated Hospital of Weifang Medical University, Weifang 261031, Shandong Province, China
Jing-Jing Chen, Department of Radiology, the Affiliated Hospital of Medical College, Qing Dao University, Qingdao 266000, Shandong Province, China
Author contributions: Dong P and Chen JJ designed the research; Dong P, Chen JJ, Wang XZ and Wang YQ performed the research; Dong P, Chen JJ, Wang XZ and Wang YQ analyzed the data; Dong P, Chen JJ, Wang XZ and Wang YQ wrote the paper.
Supported by Project of Medicine and Health Development Plan of Shandong Province, No. 2011HZ112, China; and Shandong Provincial Natural Science Foundation of China, No. ZR2014HL083.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the Affiliated Hospital of Weifang Medical University.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest in this study.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Peng Dong, MD, Professor, Medical Imaging Center, the Affiliated Hospital of Weifang Medical University, Shenglidong Street, Weifang 261031, Shandong Province, China. dongpeng98021@sina.com
Telephone: +86-536-8462397 Fax: +86-536-8462397
Received: March 2, 2015
Peer-review started: March 4, 2015
First decision: April 24, 2015
Revised: May 12, 2015
Accepted: July 18, 2015
Article in press: July 27, 2015
Published online: September 28, 2015
Processing time: 224 Days and 23.8 Hours
Abstract

AIM: To evaluate the computed tomography (CT) features of intraperitoneal tuberculous abscess (IPTA).

METHODS: Eight patients with IPTA confirmed by pathology were analyzed retrospectively. The clinical symptoms, medical images, and surgical findings were evaluated. Involvement of the intestine, peritoneum, viscera, and lymph nodes was also assessed.

RESULTS: All 8 patients had a history of abdominal discomfort for 1 to 6 mo. Physical examination revealed a palpable abdominal mass in 6 patients. Three patients had no evidence of pulmonary tuberculosis (TB). All IPTAs (11 abscesses) were seen as a multiseptated, peripherally enhanced, hypodense mass with enlarged, rim-enhanced lymph nodes. The largest abscess diameter ranged from 4.5 cm to 12.2 cm. CT showed 2 types of IPTA: Lymph node fusion and encapsulation. Of the 8 patients, one had liver tuberculosis and one had splenic and ovarian tuberculosis. Two cases showed involvement of the terminal ileum and ileocecal junction. Ascites were found in 4 cases. Three patients had peritonitis and mesenteritis. Three patients showed involvement of the omentum. Three patients had histological evidence of caseating granuloma, and 5 had histological evidence of acid-fast bacilli.

CONCLUSION: CT is crucial in the detection and characterization of IPTA. Certain CT findings are necessary for correct diagnosis.

Keywords: Tuberculosis; Abdomen; Abscess; Diagnosis; Computed tomography; X-ray

Core tip: Intra-peritoneal tuberculous abscess (IPTA) is a rare and serious form of extra-pulmonary tuberculosis. Early and accurate diagnosis of tuberculous abscess is important for treatment. This retrospective study was to evaluate the computed tomography (CT) features in 8 patients with pathologically confirmed IPTA. CT is crucial in the detection and characterization of IPTA. Although the qualitative diagnosis of IPTA requires positive pathologic findings, certain CT features (such as a multiseptated, peripherally enhanced, hypodense mass with rim-enhanced lymph nodes, peritoneum/mesentery/omentum changes) are necessary for correct diagnosis.