Ultrasound diagnosis of "dry type" ileocecal tuberculosis: a case report.
Abdominal tuberculosis is a common curable disease in third world countries. CT is the most sensitive imaging technique. The purpose of this paper is to report the ultrasound diagnosis of a missed dry type ileocecal tuberculosis. A 40 year old patient was admitted to hospital for loin pain and was discharged following negative ultrasound and IVU tests. Symptoms recurred and a barium enema, follow through and abdominal CT were conducted. Barium studies were non specific and CT was normal. Sigmoidoscopy was negative for inflammatory bowel disease. A second ultrasound indicated a "coned" cecum with edematous and dilated terminal ileum. A diagnosis of tuberculosis was suggested. Colonoscopy showed typical lesions in the cecum with nodular terminal ileum. Biopsies were supportive of a tuberculosis diagnosis. In conclusion, an ultrasound with a high index of clinical suspicion is a useful test for the diagnosis of ileocecal tuberculosis. The coned contracted cecum with a dilated edematous terminal ileum are important diagnostic signs.
Abd el Bagi
M
M
Department of Radiology, Armed Forces Hospital, Riyadh, Saudi Arabia.
al Karawi
M A
MA
D000328:Adult; D001706:Biopsy; D002429:Cecal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D003113:Colonoscopy; D019160:Endosonography / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007077:Ileal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014385:Tuberculosis, Gastrointestinal / Q000000981:diagnostic imaging* / Q000473:pathology