Ileocecal tuberculosis
Updates to Article Attributes
Body
was changed:
Gastrointestinal tuberculosis refers to the infection of abdominal organs with Mycobacterium tuberculosis. It generally affects the following organs:
- ileocaecum (terminal ileum and caecum)
-: mostcommon duecommonly due to abundance of lymphoid tissue 1 - colon
- liver
- spleen
- peritoneum
- lymph nodes
A point worthy of mention is that tuberculosis can affect virtually any organ system directly (primary pulmonary tuberculosis) or indirectly (via spread from primary).
This article deals with Ileocaecal tuberculosis. See related articles for other sites of involvement in the abdomen.
Pathology
Three types are known:
- ulcerative
- hypertrophic
- ulcerohypertrophic
Radiographic features
Ultrasound
Non specificNonspecific and may show
- caecal wall thickening
- lymphadenopathy
Fluoroscopy - Barium: barium studies
- acute to subacute stage
- narrowing of terminal ileum
- thickening & gaping of
ileo-caecalileocaecal valve - thickening & hypermotility of caecum
- chronic stage
- ileocaecal valve appears fixed, rigid and incompetent
- caecum appears conical in shape and shrunken in size
- pulled-up caecum (away from RIF) due to fibrotic changes in mesocolon
CT
May show
- circumferential wall thickening of terminal ileum & caecum
- asymmetric thickening of the ileocecal valve
- mesenteric lymphadenopathy with central low attenuation areas
- involvement of other organs (such as lung)
Differential diagnosis
General imaging differential considerations include
-
Crohn
's diseasedisease- more terminal ileal involvement compared with tuberculosis, which has more pronounced caecal involvement
- less/no ascites
- vascular engorgement and fibrofatty proliferation of mesentery
- caecal carcinoma (colorectal carcinoma)
- eccentric caecal wall thickening
- evidence of metastatic disease
-
small bowel lymphoma
- very thick (>
;2cm;2 cm thickness) bowel wall - lack of stricturing
- associated lymphadenopathy +/- hepatosplenomegaly
- very thick (>
-
amebiasis
-: affecting the intestines
-<li>ileocaecum (terminal ileum and caecum) - most common due to abundance of lymphoid tissue <sup>1</sup>- +<li>ileocaecum (terminal ileum and caecum): most commonly due to abundance of lymphoid tissue <sup>1</sup>
-</ul><h4>Radiographic features</h4><h5>Ultrasound</h5><p>Non specific and may show</p><ul>- +</ul><h4>Radiographic features</h4><h5>Ultrasound</h5><p>Nonspecific and may show</p><ul>
-</ul><h5>Fluoroscopy - Barium studies</h5><ul>- +</ul><h5>Fluoroscopy: barium studies</h5><ul>
-<li>thickening & gaping of ileo-caecal valve </li>- +<li>thickening & gaping of ileocaecal valve </li>
-<li>asymmetric thickening of the ileocecal valve</li>- +<li>asymmetric thickening of the <a title="Ileocecal valve" href="/articles/ileocaecal-valve">ileocecal valve</a>
- +</li>
-<a href="/articles/crohn-disease-1">Crohn's disease</a><ul>- +<a href="/articles/crohn-disease-1">Crohn disease</a><ul>
-<li>caecal carcinoma (<a title="Colorectal carcinoma" href="/articles/colorectal-carcinoma">Colorectal carcinoma</a>)<ul>- +<li>caecal carcinoma (<a href="/articles/colorectal-carcinoma">colorectal carcinoma</a>)<ul>
-<li>very thick (>2cm thickness) bowel wall</li>- +<li>very thick (>2 cm thickness) bowel wall</li>
-<a href="/articles/amoebic-colitis">amebiasis</a> - affecting the intestines</li>-</ul><p> </p>- +<a href="/articles/amoebic-colitis">amebiasis</a>: affecting the intestines</li>
- +</ul>
Tags changed:
- tuberculosis
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