Ultrasound diagnostics of abdominal tuberculosis in the conditions of the outpatient-diagnostic department
Objective: To develop ultrasound semiotics for primary verification of abdominal tuberculosis (ATB) at the outpatient stage of the survey. Methods: 121 patients with ATB (group I, primary) and 68 patients (group II, control) with abdominal lesions of nontuberculous aetiology (hepatitis B, C, cirrhosis, cardiac abnormalities with ascites, kidney failure with ascites, ovarian cancer) were analyzed and compared using ultrasound examination. Results: Statistically significant differences in the ultrasound pattern of the compared groups were obtained (p<0.001): in groups I and II, the tendency to early consolidation of the ascitic fluid and the formation of inter-serpentine «encapsulated pockets» were detected in 56.2±3.9% and 5.8±4.9% of the cases, respectively. Acoustic heterogenity of ascites fluid - in 66.9±3.2% and 22.1±3.9% observations. The presence of an infiltrate in the right ileocecal angle was found in 53.7±3.0%, the peritoneum thickening in 95.8±2.6%, and fibrin filaments between the peritoneal sheets in 58.6±3.1% of patients I group. Conclusions: With limited capabilities of general medical practitioners, ultrasound can sufficiently differentiate specific manifestations of ATB (abdominal thickening, fibrinose-adhesive overlays on the intestine and peritoneum, enlargement of mesenteric lymph nodes, infiltrates in the right ileocecal angle, fibrin filaments between the peritoneal sheets and echogenic components against the background of ascites fluid) from the nontuberculous changes in the abdominal cavity.