Ileocecal, colonic, and peritoneal tuberculosis: role of imaging in diagnosis. A case report and literature review

• Published in: Journal of medical ultrasonics (2001) Vol. 41; no. 1; pp. 77 - 82
• Main Authors: Badea, Radu, Chiorean, Liliana, Matei, Dana, Bodea, Raluca, Caraiani, Cosmin, Botan, Emil
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.01.2014; Springer; Springer Nature B.V
• Subjects: Abdomen; Ascites; Biopsy; Case Report; Case reports; Contrast agents; Diagnosis; Diagnostic imaging; Edema; Gastrointestinal diseases; Granulomas; Imaging; Infections; Infectious diseases; Literature reviews; Lymphatic system; Medical imaging; Medicine; Medicine & Public Health; Neoplasms; Pathogens; Peritonitis; Public health; Radiology; Signs and symptoms; Small intestine; Tomography; Tuberculosis; Ulcers; Ultrasonic imaging; Ultrasound; Contrast-enhanced ultrasound; Computed tomography; Intestinal tuberculosis
• ISSN: 1346-4523; 1613-2254
• DOI: 10.1007/s10396-013-0468-x

Tuberculosis is a widespread infectious disease that still remains a deadly global health problem and a condition that is life-threatening if misdiagnosed. Extrapulmonary manifestations are prevalent in the endemic areas but limited to the immunocompromised and immigrants in economically developed areas. False diagnostic situations rely on non-specific investigatory findings, the wide spectrum of clinical manifestations, and problems in discriminating between inflammation and neoplasms of the bowel. For an early diagnosis, a high index of suspicion and correlation of clinical and imaging aspects, as well as findings from colonoscopy, tissue biopsy, and microbiologic assessments, are necessary. We present a case of a patient with non-specific abdominal symptoms, mimicking a clinical syndrome of neoplastic impregnation, finally diagnosed as ileal tuberculosis with peritoneal involvement. We stress the importance of ultrasonography as a primary method of investigation, having an important role in raising the suspicion of an infectious bowel disease, as well as the role of contrast-enhanced ultrasound examination.