PURPOSE: To evaluate the CT features of abdominal tuberculosis by the pattern anaylsis. MATERIALS AND METHODS: We retrosepctively reviewed the CT findings of confirmed abdominal tuberculosis in 16 patients. Of the 16 patients, 1 was man and the remaining 15 were women with an average age of 34.1 years and the highest incidence in the twenties of age. Intravenous and oral contrast agents were used in all patients. The amount and location of ascites and the changes in the omenturn, mesentery, bowel wall, and peritoneum were analyzed. The morphologic feature, size and main compartment of involvement were also evaluated in the cases with lymphadenopathy as well as other changes in intraabdominal organs. RESULTS: The abdominal tuberculosis was more common in the female(15/16, 93.8%) and could be classified into 3 patterns on their CT findings;Complex ascitic, lymphadenopathy, or abscess forms. The complex ascitic form(10/16, 62.5%) was most commonly seen and characterized by uneven distribution and Ioculation of intraperitoneal fluid collection and marked changes of the omenturn and mesentery. The lymphadenopathy form(3/16, 18.8%) was characterized by central low density and peripheral rim enhancement on postcontrast CT with common involvements of porta hepatis and upper abdominal and paraaortic lymph nodes. The abscess form(3/16, 18.8%) was mainly related to the pelvic abscesses. CONCLUSION: CT was valuable in analyzing the patterns of the lesions and making a diagnosis of abdominal tuberculosis.
Abscess ; Ascites ; Contrast Media ; Diagnosis ; Female ; Humans ; Incidence ; Lymph Nodes ; Lymphatic Diseases ; Mesentery ; Peritoneum ; Tuberculosis*

Theincidence of envenoming from king cobra, Ophiophagus hannah in human is relatively rare. Its venom acts on the postsynaptic region of the neuromuscular junction causing descending flaccid paralysis. Locked-in syndrome is a clinical state of inability to provide motor response in a conscious patient. Many reported cases of locked-in syndrome following neurotoxic snake-bite mimics brain death. We report a case of a middle aged man who presented with progressive neurological deficit following a king cobra bite over his right arm. He had local and systemic neurotoxic envenoming. His condition deteriorated, and was intubated and ventilated in the emergency department. He received a total of 33 vials of the Ophiophagus hannah monospecific antivenom and subsequently recovered well with no neurological deficit. Retrospectively, he was able to recall the events and while he was lying paralysed and intubated under minimal sedation in the intensive care unit. He described it as a terrifying and painful experience. This case highlights the rare presentation of locked-in syndrome following a systemic envenoming from a king cobra bite. It is important to differentiate neurotoxic snake envenoming lock-in syndrome from brain dead. Patients are unable to respond to physical pain and require adequate analgesia. A patient suffering this highly distressing experience may require psychological support.