Abdominal CT Findings to Distinguish between Tuberculous Peritonitis and Peritoneal Carcinomatosis
Aphinya Charoensak MD*, Pavinee Nantavithya MD*, Piyaporn Apisarnthanarak MD*
Affiliation : * Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : Determine useful CT findings for differentiation between tuberculous peritonitis and peritoneal carcinomatosis.
Material and Method: Abdominal CT scans in 27 clinically or pathologically proven cases of tuberculous peritonitis and
53 pathologically proven cases of peritoneal carcinomatosis were retrospectively reviewed. CT findings were assessed for
ascites, abnormalities of peritoneum, omentum, and mesentery, abdominal lymphadenopathy, and other associated findings
in abdomen, bone, and lung bases. Statistical differences of CT findings between two diseases were analyzed using
Chi-square or Fisher’s exact test.
Results : Fibrin in ascites was found in 5/26 patients with tuberculous peritonitis but none in peritoneal carcinomatosis
(p < 0.05). Smooth and uniform peritoneal thickening was more frequently seen in tuberculous peritonitis (p < 0.001), but
irregular peritoneal thickening and peritoneal nodules were more frequently seen in peritoneal carcinomatosis (p < 0.001).
Type of omental abnormalities showed significantly differed between two diseases (p < 0.001). Smudge type was more
commonly found in tuberculous peritonitis, while nodular and cake types were more commonly detected in peritoneal
carcinomatosis. Lymph nodes size < 1 cm and location of lymph nodes at peripancreatic region were more frequently
identified in tuberculous peritonitis, whereas lymph nodes size ≥ 1 cm and contour abnormality of the liver or the spleen
were more frequently visualized in peritoneal carcinomatosis (p < 0.05).
Conclusion : Although some CT findings were overlapped, the present study addressed some useful CT findings for
differentiation between tuberculous peritonitis and peritoneal carcinomatosis.
Keywords : Computed tomography, Tuberculosis, Peritonitis, Peritoneal carcinomatosis
