Abdominální tuberkulóza v CT obrazu

Abdominal Tuberculosis in CT Imaging

According to WHO declaration, tuberculosis is considered the world health danger. Almost 1 % of world population is infected by tuberculosis every year and up to 3 millions of new cases are registered in the south-east Asia only. Prevalence of extra-pulmonary tuberculosis is rising, which is probably caused by the rising prevalence of AIDS. Fifty eight years old man, the immigrant from south-east Asia was accepted in a subileous state at the department of Internal medicine. He had suffered for longer period from the torpidness, tabescence and other non-specific symptoms. Among results of laboratory tests, the higher erythrocyte sedimentation and elevation of liver tests were conspicuous. After the colonoscopy, suspicion on the Crohn’s disease was expressed. CT examination revealed several segments of the infected intestine. Both the small and large intestine were affected with skip-lesions; short afflicted segments had not the passage impaired with no ring-like dilatations. Mesenterial, periportal and retroperitoneal lymph nodes were enlarged. In the small pelvis, between the intestine and at the dorsal margin of the liver, some free fluid was visible. Abdominal parenchymatose organs had no obvious focal afflictions. In the differential diagnose, the Crohn’s disease and the malignant lymphoma were considered. The probatory laparoscopy gave the correct diagnosis of the abdominal tuberculosis. Prevalence of tuberculosis is rising in the whole world, and in western countries rare cases of extrapulmonary tuberculosis can be found. A higher attention is necessary in cases of immuno-suppressed patients, who earlier lived in countries with endemic tuberculosis, or in cases of patients originating in those countries.

Key words:
computer tomography, abdominal tuberculosis.