Abstract:

The abdominal CT scans of seven patients with tuberculous peritonitis combined with intestinal perforation were retrospectively reviewed. We analyzed the CT features of the patients, including peritoneum, omentum, mesentery, retroperitoneal space, and abdominal parenchymal viscera. The main features in the abdominal CT scans of tuberculous peritonitis combined with intestinal perforation appeared as follows. (1) Large encapsulated effusion and gas abscess were found in five cases. (2) One case of free gas under the diaphragm was identified. (3) Multiple small bubbles surrounding the bowels and abdominal cavity were present in seven cases. (4) Intestinal obstruction was found in four cases. (5) Small amount of free ascites with high density were identified in seven cases. (6) Peritoneum and retinal thickening were found in seven cases. (7) The mesentery of seven cases showed a “smudge” change. (8) Secondary pulmonary tuberculosis were identified in six cases, combined hematogenous disseminated pulmonary tuberculosis happened in one patient and combined tuberculous pleurisy were found in two cases. (9) Six cases were found with combined secondary hydronephrosis. Therefore, the CT scan features of tuberculous peritonitis combined with intestinal perforation may appear as a small amount of free ascites, peritoneal thickening, omental and mesenteric involvement. Acute perforation is indicated when free gas under the diaphragm occurs. In addition, chronic perforation is indicated when large encapsulated effusion and gas abscesses appear in the abdominal cavity and surrounding the bowels, multiple small bubbles appear in the omentum and mesentery. CT scan can provide important information for the diagnosis of tuberculous peritonitis combined with intestinal perforation.

Key words: Peritonitis, tuberculous, Intestinal perforation, Tomography, spiral computed, Diagnostic imaging, Disease attribute