The various ultrasound (US) findings in 90 patients with abdominal (ga
strointestinal, peritoneal, mesenteric and lymph node) tuberculosis (T
B) studied in an area of high incidence of TB over a 1 year period wer
e analysed. The lesions encountered were intestinal(n=31), extraintest
inal (n=39), or a combination (n=20). The extraintestinal lesions incl
uded free and loculated ascites (n=36), localized ascites ('Club Sandw
ich sign') (n=4), adhesions (n=14), peritoneal thickening (n=14), peri
toneal nodules (n=3), lymphadenopathy (n=23) and cold abscesses (n=10)
- of these, the presence of fine fibrinous strands in the ascetic flu
id, localized ascites and caseous or calcified lymph nodes were highly
suspicious of a diagnosis of TB in appropriate clinical settings. The
bowel lesions were characterized by concentric bowel wall thickening
(n=31) with ulceration in six. Bowel thickening, when present in the i
leocaecal junction and especially when situated in the subhepatic posi
tion, was suggestive of a tuberculous etiology. Complex masses in the
abdomen pointed to an advanced stage of the disease. US is a useful im
aging modality in patients clinically suspected of having abdominal TB
for diagnosis and follow-up, although in a few cases differentiation
of it from metastatic disease is difficult. When bowel involvement is
suspected, barium studies should be performed.