Peritoneal Tuberculosis and Closed-Loop Small Bowel Obstruction: Radiologic Insights, Pathophysiology, and Management
Keywords: Peritoneal tuberculosis, Closed-loop small bowel obstruction, Abdominal tuberculosis, CT imaging, Small bowel ischemia, Radiology case review, Peritoneal thickening, Omental caking 1. Introduction Peritoneal tuberculosis (PTB) and closed-loop small bowel obstruction (SBO) represent a rare yet critical diagnostic combination that challenges even experienced radiologists and surgeons. While peritoneal tuberculosis is an insidious manifestation of Mycobacterium tuberculosis infection, typically mistaken for peritoneal carcinomatosis due to its nonspecific imaging features, closed-loop small bowel obstruction constitutes a surgical emergency with high risk of ischemia and necrosis. This article reviews a classic case of a 64-year-old man with peritoneal tuberculosis–induced adhesional closed-loop SBO , illustrating the imaging findings, pathophysiology, epidemiology, differential diagnosis, and evidence-based management based on recent WHO and radiologic litera...