Background
Intestinal tuberculosis frequently causes abdominal pain.
Objective
To describe ultrasound in management of intestinal tuberculosis.
Patients and methods
This retrospective study was conducted at St Elisabeth Hospital, Flores, during February 2012 - August 2013 using ALOKA SD1100. Data were abstracted from medical records of all completed treated of intestinal tuberculosis cases.
Result
N 546(14-85y, x36,5y), 312(57%) female, 234(43%) male.
Preceding treatment
All with recurrent colic abdomen pain (some very severe), diarrhea/obstipation, distention, “doughy & dam-board phenomena”, constitutional symptoms, cough and X-ray suggestive lung tuberculosis. Intestinal ultrasound on the tympanic area were normal, but on dullness pain area were: a/hypo-peristaltic, irregular thickening heterogenic hypo-echoic, irregular margin of the wall, loss differentiation of the wall layers, with several oval/round nodular structures (patchy hyper-echoic non-shadowing with an irregular rim of lower echo-density, those suggestive granuloma process) within the wall and narrowing of the lumen.
During 9-12 months of anti tuberculosis treatment
all the symptoms & signs, dullness area, wall thickening, lumen narrowing were disappeared gradually with better peristaltic at the affected area.
After the treatment
no abdominal pain/tenderness/doughy abdomen/dullness area/ constitutional sign &symptoms anymore. Only 292 (53%) then carried ultrasound at the end of treatment (economic reason) showed intestine wall thickening were decreased and normal peristaltic were seemed on the affected area, but the wall margin were still irregular.
Conclusion
Ultrasound was very useful for more thorough diagnosis & follow-up the treatment of intestinal tuberculosis.
References
- 1.AWARD FOR THE BEST PRESENTATION. WINFOCUS ENCOUREGEMENT AWARD . The 5th World Congress Ultrasound on Emergency and Intensive Medicine Care. Sydney: WINFOCUS (World Interactive Network Focused on Critical Ultrasound); 2009. Recurrent Abdominal Pain Among The Disseminated Tuberculosis Cases In Saumlaki Community Health Centre, Tanimbar, The Remote Boundary Islands In West Of South-East Mollucas Indonesia. [Google Scholar]
- 2.Ultrasound Findings Of Abdominal Pain in Intestinal and Peritonitis TuberculosisThe 3rd World Congress Ultrasound On Emergency And Intensive Medicine Care In Paris 2007.