Radiological Findings in a Patient Presenting with Chronic Abdominal Pain as a Secondary Manifestation of Pulmonary Tuberculosis
Published: December 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/66227.18839
Saurav Shreyas Date, Suresh Vasant Phatak, Avinash Parashuram Dhok, Adnan Ilyas, Gajanan Kishor Wattamwar
1. Junior Resident, Department of Radiodiagnosis, NKP Salve Institute of Medical Sciences and Research Centre, Lata Mangeshkar Hospital, Nagpur, Maharashtra, India.
2. Professor, Department of Radiodiagnosis, NKP Salve Institute of Medical Sciences and Research Centre, Lata Mangeshkar Hospital, Nagpur, Maharashtra, India.
3. Professor and Head, Department of Radiodiagnosis, NKP Salve Institute of Medical Sciences and Research Centre, Lata Mangeshkar Hospital, Nagpur, Maharashtra, India.
4. Junior Resident, Department of Radiodiagnosis, NKP Salve Institute of Medical Sciences and Research Centre, Lata Mangeshkar Hospital, Nagpur, Maharashtra, India.
5. Junior Resident, Department of Radiodiagnosis, NKP Salve Institute of Medical Sciences and Research Centre, Lata Mangeshkar Hospital, Nagpur, Maharashtra, India.
Correspondence
Dr. Suresh Vasant Phatak,
Bakul Apartment, Near LAD Square Metro Station, Nagpur-440019, Maharashtra, India.
E-mail: suresh_phatak@yahoo.com
A 32-year-old female patient presented with complaints of loss of appetite, weight loss (8-9 kg), and generalised weakness for three months. The patient also had a history of cough with expectoration for two months accompanied by abdominal pain, particularly on the left-side, and low-grade, intermittent fever for the last two weeks. The Erythrocyte Sedimentation Rate (ESR) was deranged, measuring 25 mm/hr. The Mantoux test was positive with an induration of 17 mm. The sputum study confirmed the diagnosis of tuberculosis by detecting acid-fast bacilli.
On ultrasound, multiple hypoechoic lesions were noted scattered throughout the splenic parenchyma (Table/Fig 1),(Table/Fig 2). They showed no vascularity on colour Doppler and no evidence of calcification (Table/Fig 3). Multiple enlarged lymph nodes were found in the preaortic, para-aortic, peripancreatic, and splenic hilum regions. Computed Tomography (CT) scan demonstrated a tree-in-bud appearance and patchy areas of consolidation in the left lung parenchyma along with multiple subcentimeter lymph nodes. Multiple variable sized hypodense areas (HU +25 to +35) were noted scattered throughout the splenic parenchyma (Table/Fig 4).
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