Unusual Presentation of a Caseating Lymphadenitis Causing Abnormal Lymphadeno-Duodenal Communication
Yamuna Jayasree *
Department of Radiology and Imaging Sciences, Sri Ramachandra University, Porur, Chennai, Tamilnadu, India.
Subramanian Ilanchezhian
Department of Radiology and Imaging Sciences, Sri Ramachandra University, Porur, Chennai, Tamilnadu, India.
Ralph Jeffery
Department of Radiology and Imaging Sciences, Sri Ramachandra University, Porur, Chennai, Tamilnadu, India.
Rajoo Ramachandran
Department of Radiology and Imaging Sciences, Sri Ramachandra University, Porur, Chennai, Tamilnadu, India.
Periasamy Varadaraju Prithiviraj
Department of Radiology and Imaging Sciences, Sri Ramachandra University, Porur, Chennai, Tamilnadu, India.
*Author to whom correspondence should be addressed.
Abstract
Aim: To describe the imaging features of a case of abnormal lymphadeno-duodenal communication caused by caseating lymphadenitis.
Presentation of Case: The case discussed is of a thirty-five year old Indian woman who presented with abdominal pain, vomiting, fever, loss of appetite and later diagnosed with abnormal lymphadeno-duodenal communication caused by caseating lymphadenitis.
Discussion: Caseating lymphadenitis is a chronic disease process that occurs anywhere in the human body and its prevalence varies from region and country. Here, we report a case of lymph node with caseous necrosis causing abnormal lymphadeno-duodenal communication which was diagnosed by Computed tomography. This poses a great diagnostic challenge for a variety of reasons which include its non-specific symptoms, wide range of causes and the complications in the case of a delayed diagnosis. Abdominal involvement can occur in the peritoneum and the mesentery. Imaging plays a very important role to assess the cause of caseating lymph nodes and identify the complications.
Conclusion: As abnormal lymphadeno-duodenal communication is an unusual condition and rarely reported, it is important to consider the possibility of tuberculosis as one of the underlying etiology. A high index of suspicion needs to be maintained for timely diagnosis and accurate treatment.
Keywords: Lymph-node, tuberculosis, duodenum, caseating