ULTRASOUND DIAGNOSIS OF DRY-TYPE ILEOCECAL TUBERCULOSIS - A CASE-REPORT

Abdominal tuberculosis is a common curable disease in third world coun tries. CT is the most sensitive imaging technique. The purpose of this paper is to report the ultrasound diagnosis of a missed dry type ileo cecal tuberculosis. A 40 year old patient was admitted to hospital for loin pain and was discharged following negative ultrasound and IVU te sts. Symptoms recurred and a barium enema, follow through and abdomina l CT were conducted. Barium studies were non specific and CT was norma l. Sigmoidoscopy was negative for inflammatory bowel disease. A second ultrasound indicated a ''coned'' cecum with edematous and dilated ter minal ileum. A diagnosis of tuberculosis was suggested. Colonoscopy sh owed typical lesions in the cecum with nodular terminal ileum. Biopsie s were supportive of a tuberculosis diagnosis. In conclusion, an ultra sound with a high index of clinical suspicion is a useful test for the diagnosis of ileocecal tuberculosis. The coned contracted cecum with a dilated edematous terminal ileum are important diagnostic signs.