The Clinical Study of Abdominopelvic Actinomycosis.
- Author:
Sung Gun LEE
1
;
Young Hoon ROH
;
Ki Jae PARK
;
Hong Jo CHOI
;
Ghap Joong JUNG
;
Myoung Seok HAN
Author Information
1. Department of Surgery, College of Medicine, Dong-A University, Busan, Korea. gspark@daunet.donga.ac.kr
- Publication Type:Original Article
- Keywords:
Actinomycosis;
Abdominal mass;
Pelvic abscess
- MeSH:
Abdominal Pain;
Abortion, Induced;
Abscess;
Actinomyces;
Actinomycosis*;
Anti-Bacterial Agents;
Appendicitis;
Causality;
Colon;
Colonic Neoplasms;
Communicable Diseases;
Diagnosis, Differential;
Disease Progression;
Diverticulitis;
Drainage;
Endometriosis;
Female;
Fibrosis;
Gynecology;
Humans;
Intrauterine Devices;
Leiomyoma;
Lymphoma;
Medical Records;
Metrorrhagia;
Obstetrics;
Ovary;
Retrospective Studies;
Tomography, X-Ray Computed;
Ultrasonography;
Ureter;
Uterus
- From:Journal of the Korean Surgical Society
2006;70(1):47-52
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Abdominal actinomycosis is a rare chronic suppurative infectious disease, caused by a gram-positive bands Actinomyces israelii organism. The pathogens produces a characteristic granulomatous inflammatory fibrosis and mass lesion. Actinomycosis is usually divided into three clinical types; cervicofascial, thoracic and abdominopelvic. This study was designed to investigate the clinical or radiologic variability and the meanings of the diagnostic differentiality of abdominopelvic actinomycosis when patients present with an unusual abdominal mass or abscess. METHODS: The medical records of 19 patients treated at the Departments of Surgery and Obstetrics and Gynecology, Dong-A University Hospital were reviewed. The clinical characteristics, diagnostic evaluation and surgical treatment results were retrospectively analyzed. RESULTS: Of the 19 patients, 7 cases involved the colon and 11 the uterus and ovary with one case also involving the retroperoneum and ureter. Most cases (84.2%) had predisposing factors of disease progression, including intrauterine device (IUD), abortion, previous surgery, appendicitis and diverticulitis. The common presentations of the patients were abdominal pain (57.8%) and a palpable mass (15.7%). Preoperatively, no case was diagnosed as actinomycosis, but misconceived as a pelvic abscess, ovarian or colon cancers, a mesenteric origin mass, a lymphoma, periappendiceal abscess, acute appendicitis, uterine myoma, dysfunctional uterine bleeding or endometriosis. Explorations were performed in all patients. Eighteen cases were cured following surgery with subsequent antibiotics. However, one case recurred due to incompletion of antibiotics following surgical drainage. CONCLUSION: Abdominopelvic actinomycosis should be included as a differential diagnosis when an unusual abdominal mass presents on abdominal CT or ultrasound. Appropriate antibiotics, as well as surgery, are important in the treatment of abdominopelvic actinomycosis.
