CT image of tuberculosis peritonitis displays and the basic _'s symptom of pathology

CT image of tuberculosis peritonitis displays and the basic _'s symptom of pathology
Wang ZhenJiang 2005-12-13 13:21:09 Traditional Chinese Medicine magazine Number 1 of Vol. 3 of January of 2003

Tuberculosis peritonitis (tuberculous peritonitis, TBP) Clinic is not rare. I am through changing and doing reviewing analysis to the CT signs and pathology of 17 TBPs, by improving the image to diagnose competence.
A material and method
This is in 17 groups, 7 men, 10 women, 19-64 years old, 37.7 average years olds. 20- The young and the middle aged 40 years old are 12. Proved TBP by pathology. 1 month of course of disease - 3 years. Main symptom suffers from abdominal pain, abdominal distension and tuberculosis are poisoned symptom. Main physical sign has light tenderness of belly, abdominal distension, the ascites,etc.. Checking in the laboratory has anaemia, and tuberculin test masculine gender that the erythrocyte sedimentation rate increases more. Check 8 in ascites, yellow of grass oozes out 7 cases of liquid, courage and uprightness oozes out 1 case of liquid; Resist acid and dye all negatively, the branch bacillus of tuberculosis trains one. Image learn, check, include CT, Ultrasonography B, the intersection of intestines and stomach and the intersection of barium meal and radiography and the intersection of X-ray and the intersection of chest and block,etc..
2 results
CT behaves: ( 1) Ascites type: 7, a large amount of ascites that CT gets while showing as, 5 of high density ascites (CT value 25- 41Hu) among them . Increase the peritoneum by thick 5, peritoneum occurs frequently in the spot calcification 1 cooking stove. Peritoneum occur frequently tiny the intersection of tubercle and cooking stove and stain peritoneum ' Mean the range peritoneum takes the form of wadding to change) 2 respectively. ( 2) Adhesion type: 6, CT is shown as 5 cases of ascites of little quantity when gets, one for a large amount of ascites, density 23- 37Hu. And present parcel distribution more. Among them 4 omentums cakes, are shown as the omentum takes the form of the bulk to increase thick, knows at the border, there are many only more whole surfaces, and strengthen in various degree. 3 CTs see the mesenterium take the form of the line shape or star awn to increase thick, occur frequently in 1.5- 2.5cm all kinds of tubercle cooking stove in 2 cases of mesenterium among them, and the majority is strengthened in ring shape; The intestines presents multistage abnormality expanding and extensive enlargement of lymph nodes in companion's belly. ( 3) Cheese type: 2, CT is shown as one kind of focuses of single shot and many room bags that the belly occurs frequently, the bag wall after strengthening, separate and strengthen slightly. ( 4) Dirty layer of peritoneum tuberculosis: Serous coat the intersection of liver and the intersection of tuberculosis and 2, CT show as liver make membrane increase thick, among them 1 see liver make under the membrane occuring frequently the intersection of tubercle and the intersection of form and low the intersection of density and cooking stove, strengthen, present the slight edge to strengthen.
This is in 17 groups, amalgamate 10 cases of tuberculosis other internal organs in belly, including scrofula, tuberculosis of intestine and liver, spleen, pancreas tuberculosis,etc..
3 is discussed
CT of TBP displays and pathologic the relevance between the type and diagnoses value: ( 1) Ascites type: CT is shown as a large amount of more high density ascites, there are certain characteristics [1] . Have peritoneum that increases the thick and granulous focus of millet more on this type pathology, and CT reveal more the peritoneum is increased even and smoothly thick, diagnose value [1- 4 ] certainly. The peritoneum calcification is uncommon, but CT is apt to reveal, and diagnose value importantly. When oozing out around the small tubercle cooking stove of millet grain of peritoneum, CT is shown as the belly membrane of stain '2] . ( 2) Adhesion type: Change after absorbing for the ascites, there is less water yield of belly in the abdominal cavity, and a large number of fibers organize hyperplasia, and peritoneum, extensive adhesion of omentum obviously increase thick. Therefore CT show as more little the intersection of quantity and high the intersection of density and ascites get, more for disperse, occur frequently parcel nature. The corresponding omentum takes the form of the irregular flat bulk to increase thick and strengthening in various degree [1- 4] . Extensive adhesion takes place and form not of uniform size lump to change for main pathology with mesenterium, mesenteric lymph node and intestines one in some cases, its CT is shown as the mesenterium is increased and taken the form of line thick, the star awn changes and occurs frequently the larger tubercle cooking stove, diagnose value certainly [1,3] . This 2 groups see mesenterium occur frequently annularly and strengthen lump and may be studied and behaved by this type characteristic image. Small intestine intestines are a of maldistribution, it is that this type common CT behaves to take the form of getting multistage abnormality expanding and companion's enlargement of lymph nodes. The mesenterium tubercle strengthens the easy differentiation in ring shape on tuberculosis spot piece and swelling lymph node CT, but diagnose value to TBP. In sum, that there is little ascites but the omentum, mesenterium pathological change are serious is the this type most prominent CT characteristic, the intersection of mesenterium and the intersection of tuberculosis and the intersection of spot and the intersection of piece and calcification [5 ] and annular to strengthen and diagnose value importantly. ( 3) Cheese type: I haven't seen you for a long time, by the ascites type more, the adhesion type develops, heavy-duty for this disease. On pathology, take a kind of necrosis of cheese as the core, organize hyperplasia and adhesion with a large number of fibers. CT is shown as one kind of focuses of much hair follicle in belly, change commonly with many room bag kind, it is a kind of necrosis and material of cheese in the bag. The bag wall after strengthening, separate it more in order to strengthen slightly, the companion obviously strengthens at the time of bacterial infection. I think, one kind of focuses especially many room bag kind of much hair follicle changes companion's bag wall in the belly, strong typical CT which turns this type tuberculosis behaves, combines the development medical history of clinical and other types TBP to separate slightly, most cases can be made correct diagnosis. ( 4) Dirty layer of peritoneum tuberculosis: Rare, serous coat type make at the membrane taking place the intersection of millet and grains of the intersection of sex and the intersection of tuberculosis and cooking stove or making membrane liver mainly at the the intersection of liver and the intersection of tuberculosis and pathology hyperplasia plump [5] . CT show as liver make membrane increase thick making under the membrane occuring frequently in the low tubercle cooking stove, there are certain characteristics.
Should notice some TBP cases proteiform CT behaving and often coexisting. Must also pay attention to amalgamating other internal organs tuberculosis in belly. Differential diagnosis, mainly distinguish with cancer peritonitis, cheese type TBP needs to distinguish with abdominal cavity's bacterial abscess.
References
1 Suri S, Gupta S, Suri R.Computed tomography in abdominal tuberculo sis.Br J Radiol, 1992, 72:92 - 98.
2 the intersection of wild goose and mountain Xue, discipline, intelligently, Liu XiuMei. CT of the tuberculosis peritoneum behaves. Chinese radiology magazine, 2000, 34:349-350.
3 Ha HK, Jung JI, Lee MS, et al.CT differentiation of tuberculous peri tonitis and peritoneal carcinomatosis.AJR, 1996, 167:743-748.
It jump for to show all to 4, Yu ChunTang,hold,etc.. Tuberculosis CT of peritonitis diagnose ' Enclose 11
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