Abdominal actinomycosis simulating malignancy of the right colon
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Dosyalar
Tarih
2005
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Dig Dis Sci.
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Actinomycosis is a chronic, suppurative, and granulomatous
disease caused by an anaerobic or microaerophilic
gram-positive bacterium, Actinomyces israelii, manifesting
itself as fistula, sinus, inflammatory pseudotumor, or
abscess formation. The cervicofacial region (50 to 65%)
accounts for the majority of the cases followed by abdomen
(20%) (1–5). Abdominal infection mostly involves
the cecal area and can simulate malignant tumor on clinical
and radiological examinations (1, 4, 6, 7). The diagnosis
is almost always ascertained after surgery and histopathological
examination of the specimen.
The purpose of this report is to emphasize the possibility
of encountering an abdominal mass related to actinomycosis
in emergency cases and the benefit of limited surgical
procedure.
A 28-year-old man was admitted to emergency room with severe right lower abdominal pain, nausea, and vomitting of a few days’ duration. He had a 4-month history of decrease in appetite but no weight loss, bloating, and vague lower abdominal pain. His further medical history revealed hospitalization for pulmonary tuberculosis 9 years prior. He denied any surgical procedures. Physical examination disclosed fever (38◦C) and tachycardia (110/min). He was noted to have a distended abdomen with guarding and rebound tenderness, especially in the right upper and lower quadrants. No abdominal mass was palpated. Abnormal laboratory values included only a leukocyte count of 15,800/mm3. Abdominal ultrasound showed pelvic free fluid and an irregular mass in the right lower quadrant. The patient underwent an emergency laparotomy with the presumptive diagnosis of perforated appendicitis and related peManuscript received March 3, 2004; accepted August 18, 2004. From the Departments of *General Surgery and †Pathology, Inonu University School of Medicine, Malatya, Turkey. Address for reprint requests: Burak I¸sik, MD, Turgut Ozal Tip Merkezi, Genel Cerrahi AD, Elazig Yolu 15 km, Malatya 44280, Turkey; bisik@inonu.edu.tr. riappendicular abscess. Approximately 200 ml of greenish purulant fluid was aspirated from the pelvis. A large firm tumor extending from the ascending colon to the hepatic flexure involving the mesocolon was identified. The second portion of the duodenum was adherent to the posterior of the mass. The decision at this juncture was to perform a right hemicolectomy versus a hemicolectomy with Whipple procedure because of the duodenal invasion. We preferred to perform a right hemicolectomy with end-to-end ileocolonic anostomosis, leaving a macroscopically evident tumor on the duodenal serosa because of not having a malignancy confirmation of the mass. Further exploration of the abdominal cavity revealed no other pathological findings.
A 28-year-old man was admitted to emergency room with severe right lower abdominal pain, nausea, and vomitting of a few days’ duration. He had a 4-month history of decrease in appetite but no weight loss, bloating, and vague lower abdominal pain. His further medical history revealed hospitalization for pulmonary tuberculosis 9 years prior. He denied any surgical procedures. Physical examination disclosed fever (38◦C) and tachycardia (110/min). He was noted to have a distended abdomen with guarding and rebound tenderness, especially in the right upper and lower quadrants. No abdominal mass was palpated. Abnormal laboratory values included only a leukocyte count of 15,800/mm3. Abdominal ultrasound showed pelvic free fluid and an irregular mass in the right lower quadrant. The patient underwent an emergency laparotomy with the presumptive diagnosis of perforated appendicitis and related peManuscript received March 3, 2004; accepted August 18, 2004. From the Departments of *General Surgery and †Pathology, Inonu University School of Medicine, Malatya, Turkey. Address for reprint requests: Burak I¸sik, MD, Turgut Ozal Tip Merkezi, Genel Cerrahi AD, Elazig Yolu 15 km, Malatya 44280, Turkey; bisik@inonu.edu.tr. riappendicular abscess. Approximately 200 ml of greenish purulant fluid was aspirated from the pelvis. A large firm tumor extending from the ascending colon to the hepatic flexure involving the mesocolon was identified. The second portion of the duodenum was adherent to the posterior of the mass. The decision at this juncture was to perform a right hemicolectomy versus a hemicolectomy with Whipple procedure because of the duodenal invasion. We preferred to perform a right hemicolectomy with end-to-end ileocolonic anostomosis, leaving a macroscopically evident tumor on the duodenal serosa because of not having a malignancy confirmation of the mass. Further exploration of the abdominal cavity revealed no other pathological findings.
Açıklama
Digestive Diseases and Sciences, Vol. 50, No. 7 (July 2005), pp. 1312–1314 (C 2005).
Anahtar Kelimeler
Abdominal actinomycosis, Actinomycosis, Actinomycosis of the colon
Kaynak
Dig Dis Sci.
WoS Q Değeri
Scopus Q Değeri
Cilt
0
Sayı
0
Künye
Işık, B., Aydın, N. E., Söğütlü, G., Ara, C., Yılmaz, S., & Kırımlıoğlu, Vedat. (2005). Abdominal Actinomycosis Simulating Malignancy Of The Right Colon . Dig Dis Sci., 0–0.
