Medical Radiology and Radiation Safety. 2026. Vol. 71. № 5

DOI:10.33266/1024-6177-2026-71-5-128-134

O.A. Afukova1, Yu.A. Abovich1, A.S. Kovaleva2, 3, M.V. Nazarov2, E.A. Slepchenko2

THE ROLE OF COMPUTED TOMOGRAPHY IN THE DIAGNOSIS OF ABDOMINAL TUBERCULOSIS. CLINICAL OBSERVATIONS

¹ Pirogov Russian National Research Medical University, Moscow, Russia

² Moscow Multidisciplinary Clinical Center «Kommunarka», Moscow, Russia

³ I.M. Sechenov First Moscow State Medical University, Moscow, Russia 

Contact person: O.A. Afukova, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

ABSTRACT

Purpose: To demonstrate the diagnostic capabilities of computed tomography (CT) in detecting abdominal tuberculosis using clinical examples and to highlight the role of this method in differential diagnosis from peritoneal carcinomatosis and other diseases of the abdominal cavity.

Material and methods: Four verified cases of abdominal tuberculosis treated at Moscow Multidisciplinary Clinical Center “Kommunarka” between 2023 and 2025 are presented. All patients underwent multidetector computed tomography of the abdomen and pelvis with intravenous bolus contrast enhancement. The examinations were performed on a GE Revolution Discovery CT HD scanner. Diagnosis was confirmed by laparoscopic biopsy and histological examination in three cases (75%) and by comprehensive clinical, laboratory, and microbiological evaluation in one case.

Results: Abdominal tuberculosis includes all forms of tuberculous lesions of the abdominal organs: peritoneal (peritonitis), gastrointestinal (involvement of the stomach, small and large intestines), and mesenteric (with predominant involvement of intra-abdominal lymph nodes). The most important CT signs that allowed suspicion of abdominal tuberculosis in the presented clinical observations were the combination of smooth, uniform thickening and pronounced contrast enhancement of the peritoneal layers, free or loculated ascites of varying severity, and involvement of the ileocecal region and terminal ileum. Pleural effusion was observed in all cases. These signs helped differentiate abdominal tuberculosis from peritoneal carcinomatosis, which is typically characterized by irregular nodular peritoneal thickening and predominant pelvic or right subdiaphragmatic involvement.

Conclusion: Although abdominal tuberculosis is a relatively uncommon condition, the combination of smooth uniform peritoneal thickening with pronounced contrast enhancement, free or loculated ascites of varying severity, and ileocecal involvement on CT should raise clinical suspicion and prompt its inclusion in the differential diagnosis with peritoneal carcinomatosis.  

Keywords:  CT, abdominal cavity, abdominal tuberculosis, peritoneal carcinomatosis

For citation: Afukova OA, Abovich YuA, Kovaleva AS, Nazarov MV, Slepchenko EA. The Role of Computed Tomography in the Diagnosis of Abdominal Tuberculosis. Clinical Observations. Medical Radiology and Radiation Safety. 2026;71(5):128–134. DOI:10.33266/1024-6177-2026-71-5-128-134

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 PDF (RUS) Full-text article (in Russian)

Conflict of interest.The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. O.A. Afukova – collection and analysis of literary material, writing the text; Yu.A. Abovich – development of the research concept, writing the text; A.S. Kovaleva – development and modification of research methods; M.V. Nazarov – statistical data processing, manuscript preparation; E.A. Slepchenko – scientific editing of the text..

Article received: 20.04.2026. Accepted for publication: 25.05.2026.