Abdominal tuberculosis shows mild circumferential wall thickening of the terminal ileum and cecum, thickening of the ileocecal valve, and a few regional nodes. adenopathy, splenomegaly, hepatomegaly, ascites, bowel involvement, pleural effusion, intrasplenic masses, and intrahepatic masses. Characteristic features were a tendency for adenopathy to prominently involve peripancreatic and mesenteric compartments, low-density centers within enlarged nodes and adenopathy adjacent to sites of gastrointestinal tract involvement. Recognition of these manifestations and maintenance of an index of suspicion, especially in patients at risk, should help optimize the correct diagnosis.
To differentiate the wall thickening from CD,the associated fibrofatty change may provide us a clue.
Tuberculosis v/s Malabsorption
Malabsorption,usually presents as dilated bowel loops on CT.However,with the findings of dilated bolwel loops alone diagnosis of malabsorption becomes difficult.On barium study,associated mucosal thickening and flocculation & segmentation of barium column provides additional clue to diagnose mlabsorption. CT has capability to provide 3D reconstruction of contrast filled small bowel compareable to barium studies by ‘Volume Rendering technique’ but demonstration of ‘ Flocculation & segmentation’ is inferior to conventional Barium.On the other hand CT also provides the status of neighbouring organs,lymphadenopath and ascitis which is not possible on Barium.