گزارش يك مورد اكتينومايكوز شكمي

Abdominal Actinomycosis: A Case Report and Review

Abdominal actinomycosis is most commonly found after appendectomy or drainage of an appendiceal abscess, nevertheless other organs such as colon, stomach, liver, gallbladder, pancreas, small intestine, anorectal region, pelvic organs or anterior andominal wall may also he involved. Usually a single viscus is affected, and disseminated intraahdominal disease is uncommon. This infection can mimic multiple disease processes and requires accurate diagnosis for successful therapy. This case of abdominal actinomycosis, is a 45-yrars-old woman who presented with vague abdominal dicsomfort and a palpable right upper-and right lower-quadrant mass; the patient developed acute abdominal pain with nausea, vomiting and intestinal obstruction. She underwent emergency surgery for intestinal obstruction. Macroscopically, peritoneal mass affecting the ascending colon, mesentery and andominal wall, was observed with tumor-like infiltration of the surrounding tissues, simulated a malignant process and thus required a hemicloectomy. Therefore, en-bloc resection of the mass and a right colectomy was performed. Histological diagnosis revealed andominal actinomycosis that complicated appendicitis and results in formaion of an actinolnycotic abscess. The patient was trated successfully by surgery and long-term antibiotic therapy. Malignant disease is often simulated by actinomycosis and laparatomy may he required to make an accurate differentiation. In view of common history that is more prevalent in this disease, either inflamed or perforated appendix is to he removed and appendiceal abscesses should be drained, and if a sinus tract persists without obvious reason, this disease should he suspected.