Ileocecal, colonic, and peritoneal tuberculosis: role of imaging in diagnosis. A case report and literature review.
Tuberculosis is a widespread infectious disease that still remains a deadly global health problem and a condition that is life-threatening if misdiagnosed. Extrapulmonary manifestations are prevalent in the endemic areas but limited to the immunocompromised and immigrants in economically developed areas. False diagnostic situations rely on non-specific investigatory findings, the wide spectrum of clinical manifestations, and problems in discriminating between inflammation and neoplasms of the bowel. For an early diagnosis, a high index of suspicion and correlation of clinical and imaging aspects, as well as findings from colonoscopy, tissue biopsy, and microbiologic assessments, are necessary. We present a case of a patient with non-specific abdominal symptoms, mimicking a clinical syndrome of neoplastic impregnation, finally diagnosed as ileal tuberculosis with peritoneal involvement. We stress the importance of ultrasonography as a primary method of investigation, having an important role in raising the suspicion of an infectious bowel disease, as well as the role of contrast-enhanced ultrasound examination.
Department of Ultrasonography, "Octavian Fodor" Institute of Gastroenterology and Hepatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Radu
R
Badea
Department of Radiology and Computed Tomography, "Octavian Fodor" Institute of Gastroenterology and Hepatology, Str. Croitorilor 19-21, 400 162, Cluj Napoca, Romania. lilichiorean@yahoo.com.
Liliana
L
Chiorean
Department of Gastroenterology, "Octavian Fodor" Institute of Gastroenterology and Hepatology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Dana
D
Matei
Department of Surgery, "Octavian Fodor" Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania.
Raluca
R
Bodea
Department of Radiology and Computed Tomography, "Octavian Fodor" Institute of Gastroenterology and Hepatology, Str. Croitorilor 19-21, 400 162, Cluj Napoca, Romania.
Cosmin
C
Caraiani
Department of Pathology, "Octavian Fodor" Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania.
Emil
E
Botan
Computed tomography; Contrast-enhanced ultrasound; Intestinal tuberculosis