The CT features of abdominal tuberculosis in children.
BACKGROUND
The last decade has seen a resurgence in the incidence and clinical presentation of tuberculosis (TB). Little data exist in the paediatric age group regarding abdominal tuberculosis (ATB) and limited reports of its CT features have been published.


OBJECTIVE
To elucidate the CT features of ATB in children.


METHODS
The medical records of 22 patients with ATB were reviewed. Data were extracted regarding the methods of diagnosis and HIV status. The plain chest films were examined and the CT scans were assessed for adenopathy, solid organ involvement, ascites, bowel wall and omental thickening and inflammatory masses.


RESULTS
Ten patients had biopsy-proven ATB, 11 had extra-abdominal TB with clinical suspicion of ATB and 1 had a positive trial of therapy. Five patients were tested for HIV and one tested positive. Thirteen patients had abnormal chest radiographs. The commonest CT finding was lymphadenopathy ( n=17), followed by solid organ involvement ( n=12), ascites ( n=5), bowel wall thickening ( n=5), inflammatory masses ( n=2) and omental thickening ( n=1).


CONCLUSIONS
The clinical features of ATB are protean. This usually results in a delay in diagnosis and impacts negatively on patient morbidity and mortality. On CT, the constellation of findings is highly suggestive of the diagnosis of ATB and, used in conjunction with clinical and laboratory data, should narrow the differential considerably. Unique findings include histologically proven active TB in calcified lymph nodes and a pancreatic TB granuloma.
Andronikou
Savvas
S
Department of Paediatric Radiology, Red Cross Children's Hospital, Rondebosch, Cape Town 7700, South Africa. docsav@mweb.co.za
Welman
Chris J
CJ
Kader
Ebrahim
E
D002114:Calcinosis / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007223:Infant; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D010179:Pancreas / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D013154:Spleen / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014385:Tuberculosis, Gastrointestinal / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D014388:Tuberculosis, Lymph Node / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging