Abdominal manifestations in tuberculosis torfs
-
Upload
michael-torfs -
Category
Health & Medicine
-
view
275 -
download
5
Transcript of Abdominal manifestations in tuberculosis torfs
![Page 1: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/1.jpg)
A 52-year old man with dyspnea, fatigue
and loss of weightM. TORFSB. CORTHOUTSB. OP DE BEECKSTAFF MEETING RADIOLOGY, 09-12-2014
![Page 2: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/2.jpg)
Case presentation
Medical history:- HIV (stopped treatment 3 years before, lost to
follow-up by the ITM)- Depression
Current medical problems:- Dyspnoea- Extreme fatigue- Weight loss (15 kgs in 3-4 months)- Diarrhea- Right testis ‘problem’ (R/ ciprofloxacin)
![Page 3: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/3.jpg)
Case presentation
Clinical examination:- Cachexia- Tachycardia- Bilateral crepitations on auscultation- Red, swollen right testis
![Page 4: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/4.jpg)
Chest radiograph
![Page 5: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/5.jpg)
Chest radiograph: imaging findings
Hilar lymphadenopathy
![Page 6: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/6.jpg)
Chest radiograph: imaging findings
Miliary pattern
![Page 7: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/7.jpg)
CT thorax
![Page 8: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/8.jpg)
CT thorax
![Page 9: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/9.jpg)
CT thorax
![Page 10: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/10.jpg)
CT thorax
![Page 11: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/11.jpg)
CT thorax
![Page 12: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/12.jpg)
CT thorax
![Page 13: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/13.jpg)
CT thorax
![Page 14: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/14.jpg)
CT thorax
![Page 15: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/15.jpg)
CT thorax
![Page 16: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/16.jpg)
CT thorax
![Page 17: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/17.jpg)
CT thorax
![Page 18: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/18.jpg)
CT thorax
![Page 19: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/19.jpg)
CT thorax
![Page 20: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/20.jpg)
CT thorax
![Page 21: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/21.jpg)
CT thorax
![Page 22: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/22.jpg)
CT thorax
![Page 23: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/23.jpg)
CT thorax
![Page 24: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/24.jpg)
CT thorax
![Page 25: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/25.jpg)
CT thorax
![Page 26: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/26.jpg)
CT thorax
![Page 27: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/27.jpg)
CT thorax
![Page 28: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/28.jpg)
CT thorax
![Page 29: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/29.jpg)
CT thorax
![Page 30: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/30.jpg)
CT thorax: imaging findings
Hypodense mediastinal lymphadenopathy with rim
enhancement
Hypodense right hilar lymphadenopathy
![Page 31: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/31.jpg)
CT thorax: imaging findings
Pericardial effusion
Splenomegaly with numerous hypodense splenic lesions
(miliary pattern)
![Page 32: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/32.jpg)
CT thorax: imaging findings
Small right adrenal calcifications
![Page 33: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/33.jpg)
CT thorax: imaging findings
Micronodules, tree-in-bud pattern
![Page 34: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/34.jpg)
CT abdomen
![Page 35: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/35.jpg)
CT abdomen
![Page 36: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/36.jpg)
CT abdomen
![Page 37: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/37.jpg)
CT abdomen
![Page 38: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/38.jpg)
CT abdomen
![Page 39: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/39.jpg)
CT abdomen
![Page 40: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/40.jpg)
CT abdomen
![Page 41: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/41.jpg)
CT abdomen
![Page 42: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/42.jpg)
CT abdomen
![Page 43: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/43.jpg)
CT abdomen
![Page 44: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/44.jpg)
CT abdomen
![Page 45: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/45.jpg)
CT abdomen
![Page 46: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/46.jpg)
CT abdomen
![Page 47: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/47.jpg)
CT abdomen
![Page 48: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/48.jpg)
CT abdomen
![Page 49: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/49.jpg)
CT abdomen
![Page 50: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/50.jpg)
CT abdomen
![Page 51: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/51.jpg)
CT abdomen
![Page 52: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/52.jpg)
CT abdomen
![Page 53: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/53.jpg)
CT abdomen
![Page 54: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/54.jpg)
CT abdomen
![Page 55: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/55.jpg)
CT abdomen
![Page 56: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/56.jpg)
CT abdomen
![Page 57: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/57.jpg)
CT abdomen
![Page 58: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/58.jpg)
CT abdomen
![Page 59: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/59.jpg)
CT abdomen
![Page 60: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/60.jpg)
CT abdomen
![Page 61: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/61.jpg)
CT abdomen
![Page 62: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/62.jpg)
CT abdomen
![Page 63: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/63.jpg)
CT abdomen: imaging findings
Splenomegaly with numerous hypodense splenic lesions
(miliary pattern)
Inflammation of the right seminal vesicles
![Page 64: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/64.jpg)
CT abdomen
Hyperenhancement of the right spermatic cord
Intussusception
![Page 65: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/65.jpg)
Diagnosis?
R/ Right orchidectomy
Pathology:- Abcedation and necrosis- Presence of numerous acid fast bacteria
Diagnosis: Disseminated tuberculosis
![Page 66: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/66.jpg)
Tuberculosis: epidemiology Leading cause of death from infection worldwide
1/3 of world population infected 2010: 8.8 million incident cases worldwide, 1.4 million deaths 1.2 million cases among HIV-infected persons Largest number of incident cases: India, China, South Africa, Indonesia,
Pakistan Highest prevalence rates (> 300 cases/100,000 population) in African
region
Increased susceptibility in patients with impaired cellular immunity HIV infection, elderly, prisoners, congregate settings, indigent/homeless
![Page 67: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/67.jpg)
Tuberculosis: pathology
M. tuberculosis: Aerobic, nonmotile bacillus Stains red with Ziehl-Neelsen stain Acid-fast: Resists discoloration with acid alcohol
Granulomatous infection/inflammation Macrophage aggregates transform into
epithelioid cells, epithelioid cells fuse to form multinucleated Langhans giant cells
Central necrosis, satellite granulomas May heal as fibrous scar or calcified lesion
![Page 68: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/68.jpg)
ABDOMINAL MANIFESTATIONS IN
TUBERCULOSIS
![Page 69: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/69.jpg)
Abdominal manifestations in tuberculosis Abdomen is the most common site of extrapulmonary TB (can be involved
without lung disease)
Abdominal lymphadenopathy is most common manifestation of abdominal TB
Any abdominal or pelvic organ or structure may be involved
Tuberculosis peritonitis
Gastrointestinal tuberculosis
Hepatosplenic tuberculosis
Renal tuberculosis
![Page 70: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/70.jpg)
Abdominal lymphadenopathy Enlarged nodes with hypoattenuating centers and
hyperattenuating enhancing rims on CT (40-60%)
With healing, nodes calcify
Enteric TB probably most common cause of mesenteric nodal calcification
26-year old patient with disseminated TB
![Page 71: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/71.jpg)
Tuberculous peritonitis
Wet type: Large amount of free or loculated ascites (higher than water density due to protein and cellular content)
Dry type: Mesenteric and omental thickening, fibrous adhesions, and caseous nodules
Difficult to distinguish from peritoneal carcinomatosis
![Page 72: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/72.jpg)
Gastrointestinal tuberculosis
Ileocecal region most commonly affected Cecum & terminal ileum are usually contracted
with wall thickening; ileocecal valve is "gaping" Regional lymphadenopathy with central caseation
Colon tuberculosis less common
24-year old patient with intestinal TB and
enterocutaneous fistula
![Page 73: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/73.jpg)
Gastrointestinal tuberculosis
42-year old patient with TB colitis
![Page 74: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/74.jpg)
Hepatosplenic tuberculosis• Micronodular, miliary• Macronodular
CT Acute lesions are hypoattenuating nodules with ill-defined, enhancing
margins Chronic: Hepatic and splenic tuberculomas tend to calcify as they heal
MR T1WI: Hypotense, minimally enhancing, honeycomb lesions T2WI: Hyperintense with less intense rim relative to surrounding liver
![Page 75: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/75.jpg)
Renal tuberculosis• 75% unilateral
• Most common CT finding is renal calcification (50%)
• IVP: "Moth-eaten" calix due to erosions and progression to papillary necrosis
• Caliectasis & hydronephrosis with irregular margins and filling defects due to caseous debris
• Irregular pools of contrast due to renal parenchymal cavitation
• Strictures of renal pelvis and infundibula www.statdx.com
![Page 76: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/76.jpg)
Ureteric and bladder tuberculosis
• Ureteric tuberculosis:- Thickened ureteric wall with
strictures- Most common in distal 1/3 of
ureter- Hydronephrosis &
hydroureter can occur upstream
• Bladder tuberculosis:- Decreased bladder volume
with wall thickening, ulceration, and filling defects
http://www.isradiology.org/tropical_deseases/tmcr/chapter5/lymphadenopathy2.htm
![Page 77: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/77.jpg)
Genital tuberculosis
Male genital tuberculosis- Affects seminal vesicles or prostate
gland, rarely testes- Occasional calcification
Female genital tuberculosis- Involves fallopian tubes in 94% of
cases- Bilateral salpingitis with strictures ±
occlusion
![Page 78: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/78.jpg)
Differential diagnosis• Abdominal lymphadenopathy:
- Metastases or lymphoma- Whipple disease- MAI infection
• Tuberculosis peritonitis:- Nontuberculous peritonitis- Peritoneal metastases and lymphoma- Mesothelioma
• Ileocecal lesions:- Amebiasis- Crohn disease- Primary cecal malignancy
• Miliary hepatic lesions:- Hepatic metastases and
lymphoma- Hepatic opportunistic infection- Sarcoidosis
• Renal Lesions:- Renal papillary necrosis- Renal transitional cell
carcinoma- Other infections
![Page 79: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/79.jpg)
DD: abdominal lymphadenopathy
41-year old man with Hodgkin lymphoma
![Page 80: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/80.jpg)
DD: abdominal lymphadenopathy
68-year old man with Whipple diseaseCourtesy of Dr. Tom Seerden (Amphia Ziekenhuis Breda) and Dr. Bart Op De Beeck
![Page 81: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/81.jpg)
DD: ileocecal lesions
55-year old female with M. Crohn
![Page 82: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/82.jpg)
Take home messages
Tuberculosis is leading cause of death from infection worldwide
TB lymphadenitis is characterised by enlarged nodes with hypoattenuating centers and hyperattenuating enhancing rims on CT (tend to calcify with healing)
Disseminated TB: look at the whole picture!
![Page 83: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/83.jpg)
Remember this patient?
![Page 84: Abdominal manifestations in tuberculosis torfs](https://reader036.fdocuments.in/reader036/viewer/2022062503/58ee94fe1a28ab39498b46a1/html5/thumbnails/84.jpg)
References
Statdx.com
Radiopaedia.org
http://www.isradiology.org/tropical_deseases/tmcr/chapter5/lymphadenopathy2.htm