 Good evening everyone, my name is Dr. Ashwini, second year post graduate in the Department of Radio Diagnosis in Arupadevati Medical College and Hospital, Puducherry. My title for today's paper presentation is, A Case Report on Tuberculosis Retroperitoneal Apsis. Introduction. Tuberculosis is an airborne infectious disease caused by mycobacterium tuberculosis and it is a major cause of morbidity and mortality particularly in developing countries like India. Extra pulmonary tuberculosis represents approximately 15% of all tuberculosis infection. Abdominal tuberculosis can involve the entire gastrointestinal tract including the peritoneum and pancreatobiliary system. However, there are no pathognomic imaging findings so the diagnosis ultimately rests on histopathological and microbiological confirmation. Case report. A 57 year old female was admitted with the compliance of our right upper abdominal and right flank pain with fever. The patient was a known case of type 2 diabetes mellitus and was on treatment with insulin for 15 years with poor glycemic control. There was no history of previous tuberculosis exposure. Then laboratory investigations. Laboratory results revealed an increased erythrocyte implantation rate and increased seriative protein and the patient had leukocytosis with a total count of around 13,500 with 86% neutrophils and 14% lymphocytes. The patient also had mild anemia with hemoglobin of around 8.9g per deciliter whereas liver function test, renal function test and blood urea nitrogen were with normal limits and blood culture for aerobic and anaerobic bacteria did not produce any significant growth. This radiograph was taken and it was normal. Radiological findings. In ultrasound there was a fairly defined collection in the right flank region with internal echogenic contents and there was evidence of peripheral vascularity on color Doppler. These are the series of coronal contrast enhanced CT images showing a large heterogeneous collection in the right perirenal and perirenal spaces with evidence of surrounding fat standing. These are the series of axial contrast enhanced CT image showing a large heterogeneous collection in the right perirenal and perirenal retroperitoneal spaces and the collection is seen confined to the retroperitoneal space with no evidence of bone erosion or bony invasion. Ultrason guided percutaneous aspiration was done. It yielded a musiness fluid which was not sufficient for mycobacteriological examination. Then exploratory laparotomy was performed. It revealed a large retroperitoneal yellowish mass containing the pus. The histopathological examination of the surgical specimen showed a epithelial granulomas with the caseous necrosis, gene cells and lympho epithelial infiltrates which are the hallmarks of mycobacterium tuberculosis infection. Then polymerase chain reaction of tuberculosis using the surgical specimen was done and the diagnosis of retroperitoneal tuberculosis was established. There was no pulmonary or spinal involvement and the patient was successfully treated with standard anti-depocular therapy. Discussion, retroperitoneal abscesses are often inserious and difficult to diagnose and cause a high rate of morbidity and mortality. The retroperitoneal infections can occur at various sites posterior to the peritoneum. These include four spaces, anterior retroperitoneal space which includes esophagus, diodenum, pancreas, bile duct, portal and splenic veins, appendix, ascending and descending colon and recto sigmoid. Posterior retroperitoneal space which includes kidney, ureters, gonadal vessels, aorta, inferior vena cava and lymph nodes. Retrofacial space which includes quadrip, spine and paraspinus muscle and pelvic retroperitoneal space which includes pre vesicle, retro vesicle, pre sacral and perirectal spaces. Retroperitoneal abscess may complicate perforated colonic carcinoma, Crohn's disease of the bowel, diverticalitis, perforated appendicitis or trauma. Other clinical conditions associated with the formation of retroperitoneal abscess include pylonephritis, renal carbuncle, tuberculosis, trauma and cancer. Abdominal tuberculosis is uncommon and generally seen in patients with severe disseminated disease. Our country is considered as an endemic area and thus reactivation of latent infection should be considered even in an immunocompetent host. Delayed presentation and a large axis formation like in our patient in cases of tuberculosis infection occur more frequently rather than in the cases of pyogenic infections. Tuberculosis may be detected by chest radiograph and abdominal computer tomography which are the most frequently used imaging modalities but there were no pathognomic criteria and there are also no specific imaging techniques for retroperitoneal abscess secondary to tubercular infection. The polymerase chain reaction is rapid and a reliable tester and the results are available within 6.5 hours with a reasonable sensitivity and excellent specificity. Standard for drug anti-tubercular therapy is the main stay in the management of abdominal tuberculosis for at least 6 months. These are my references. Thank you.