CT findings of tuberculous peritonitis

Na-ChiangMai W, Pojchamarnwiputh S, Lertprasetsuke N, Chitapanarux T
Correspondence: Dr Wittanee Na-ChiangMai, wnachian@mail.med.cmu.ac.th

ABSTRACT
Introduction The diagnosis of tuberculous peritonitis is still challenging and very important. Early and accurate diagnosis leads to an effective therapy and good survival rates. With the widespread use of computed tomography (CT) in the abdomen, it is important to be familiar with the spectrum of CT appearances seen in tuberculous peritonitis. Our retrospective study aims to describe the common CT features of this disease.
Methods Abdominal CT images in 17 patients with tuberculous peritonitis in our institution from January 2002 to December 2005 were retrospectively reviewed. CT findings were evaluated for the presence of ascites, the abnormal patterns of mesentery, omentum and peritoneum.
Results Ascites and mesentery involvement were present in all patients. The most common pattern of mesenteric changes was thickened soft tissue strands with crowded vascular bundles (65 percent). The involvement of the omentum was present in 15 patients (88 percent), and the most common type was smudged pattern (82 percent). Peritoneal involvement was present in 15 patients (88 percent). Smooth uniform thickening pattern was the most common type (76 percent).
Conclusion Common features in the patients with tuberculous peritonitis include the combination of free ascites, thickened strands with crowded vascular bundles within the mesentery, smudged pattern of the omental involvement and smooth uniform thickening of the peritoneum.

Keywords: computed tomography, mesentery, omentum, peritoneum, tuberculous peritonitis
Singapore Med J 2008; 49(6): 488-491