Ileocecal tuberculosis
Updates to Article Attributes
Body
was changed:
Ileocaecal tuberculosis is the most common site of gastrointestinal tuberculosis, which in turn is the third most common site of extrapulmonary tuberculosis.
Pathology
Three morphological types of ileocaecal tuberculosis are known:
- ulcerative
- hypertrophic
- ulcerohypertrophic
Radiographic features
Ultrasound
Ultrasound is non-specific but may show caecal wall thickening and/or lymphadenopathy.
Fluoroscopy
Barium study
- acute-to-subacute stage
- narrowing of the terminal ileum
- thickening and gaping of the ileocaecal valve
- thickening and hypermotility of the caecum
- Stierlin sign: acute-on-chronic
- chronic stage
- ileocaecal valve appears fixed, rigid and incompetent
- caecum appears conical in shape and shrunken in size
- pulled-up caecum (away from the right iliac fossa) due to fibrotic changes in the mesocolon
CT
- circumferential wall thickening of terminal ileum and caecum
- asymmetric thickening of the ileocaecal valve
- mesenteric lymphadenopathy with central low attenuation areas
- involvement of other organs (e.g. lung)
{{youtube:https://www.youtube.com/watch?v=ERsTwPJEdkU}}
Differential diagnosis
General imaging differential considerations include:
-
Crohn disease
- more terminal ileal involvement compared with tuberculosis, which has more pronounced caecal involvement
- less/no ascites
- vascular engorgement and fibrofatty proliferation of mesentery
- caecal carcinoma (colorectal carcinoma)
- eccentric caecal wall thickening
- evidence of metastatic disease
-
small bowel lymphoma
- very thick (>2 cm thickness) bowel wall
- lack of stricturing
- associated lymphadenopathy +/- hepatosplenomegaly
- amoebic colitis
-<p><strong>Ileocaecal tuberculosis</strong> is the most common site of <a href="/articles/ileocaecal-tuberculosis-1">gastrointestinal tuberculosis</a>, which in turn is the third most common site of <a href="/articles/extrapulmonary-tuberculosis-1">extrapulmonary tuberculosis</a>. </p><h4>Pathology</h4><p>Three morphological types of ileocaecal tuberculosis are known:</p><ul>- +<p><strong>Ileocaecal tuberculosis</strong> is the most common site of gastrointestinal tuberculosis, which in turn is the third most common site of <a href="/articles/extrapulmonary-tuberculosis-1">extrapulmonary tuberculosis</a>. </p><h4>Pathology</h4><p>Three morphological types of ileocaecal tuberculosis are known:</p><ul>
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