Chronic abdominal pain.

Marked peritoneal thickening extending into the mesentery can occur with malignant infiltration but is usually very nodular and distributed irregularly. Pseudomyxoma peritonei can produce diffuse generalized infiltration in the mesentery and surrounding the liver and spleen, but on CT has a low attenuation similar to ascites. Tuberculous peritonitis classically produces generalized, diffuse peritoneal and mesenteric thickening reflected in CT appearances as replacement of most of the mesenteric fat with higher attenuation substance within which there are fluid collections and residual compressed mesenteric fat. The very low attenuation liver parenchyma within which the portal veins and inferior vena cava are clearly delineated on unenhanced CT is almost pathognomonic of fatty infiltration. Liver infiltration in glycogen storage disease (in children) may produce a similar appearance in the liver. Tuberculosis was confirmed and the patient was much improved on treatment.