J R Cintron1, A Del Pino, B Duarte, D Wood. 1. Department of Surgery, The West Side Veterans Administration Hospital and Medical Center, Chicago, Illinois 60612, USA.
Abstract
PURPOSE: Actinomyces israelii are normal inhabitants in the oral cavity and upper intestinal tract of humans. They rarely cause disease and are seldom reported as pathogens. As a pathogen it causes fistulas, sinuses, and may appear as an abdominal mass and/or abscess. The abdominal mass can masquerade as a malignant process that is very difficult to differentiate, often requiring surgical intervention with resection. Because of difficulty in making a preoperative diagnosis, we undertook this review to determine if all patients require surgical intervention and whether other adjunctive modalities may improve preoperative diagnosis. METHODS: We report two patients with abdominal actinomycosis, one affecting the sigmoid colon and the other the retroperitoneum, iliac crest region. Both simulated a malignant process and required operations for diagnosis and treatment. RESULTS: As reported, actinomycotic abdominal masses and strictures can be treated by penicillin alone. Long-term medical treatment seems to be very successful and avoids surgical resection. The difficulty is obtaining a definitive diagnosis. CONCLUSION: The computed tomographic scan is the most helpful diagnostic modality. Appearance of abdominal actinomycosis is usually a contrast enhancing multicystic lesion as was found in these two patients. Needle aspiration cytology can be fairly accurate in obtaining the diagnosis and is recommended for suspicious lesions.
PURPOSE:Actinomyces israelii are normal inhabitants in the oral cavity and upper intestinal tract of humans. They rarely cause disease and are seldom reported as pathogens. As a pathogen it causes fistulas, sinuses, and may appear as an abdominal mass and/or abscess. The abdominal mass can masquerade as a malignant process that is very difficult to differentiate, often requiring surgical intervention with resection. Because of difficulty in making a preoperative diagnosis, we undertook this review to determine if all patients require surgical intervention and whether other adjunctive modalities may improve preoperative diagnosis. METHODS: We report two patients with abdominal actinomycosis, one affecting the sigmoid colon and the other the retroperitoneum, iliac crest region. Both simulated a malignant process and required operations for diagnosis and treatment. RESULTS: As reported, actinomycotic abdominal masses and strictures can be treated by penicillin alone. Long-term medical treatment seems to be very successful and avoids surgical resection. The difficulty is obtaining a definitive diagnosis. CONCLUSION: The computed tomographic scan is the most helpful diagnostic modality. Appearance of abdominal actinomycosis is usually a contrast enhancing multicystic lesion as was found in these two patients. Needle aspiration cytology can be fairly accurate in obtaining the diagnosis and is recommended for suspicious lesions.
Authors: Hye Young Sung; In Seok Lee; Sang Il Kim; Seung Eun Jung; Sang Woo Kim; Su Young Kim; Mun Kyung Chung; Won Chul Kim; Seong Tack Oh; Won Kyung Kang Journal: J Korean Med Sci Date: 2011-06-20 Impact factor: 2.153
Authors: Kyoung Taek Lim; Seung Jin Moon; Joon Seok Kwon; Young Woo Son; Hong Yong Choi; Yun Young Choi; Ju Yeon Pyo; Yong Wook Park; Hong Sang Moon Journal: Korean J Urol Date: 2010-06-21
Authors: Sammy A Baierlein; Anja Wistop; Christian Looser; Thomas Peters; Hans-Martin Riehle; Markus von Flüe; Ralph Peterli Journal: Obes Surg Date: 2007-08 Impact factor: 4.129
Authors: Aniruddha S Bhuiyan; Krishna Chaitanya K H; Vikas M; Vikram H N; Avijeet Mukherjee; Thulasi Vasudevaiah; Srinath R Journal: Indian J Surg Date: 2011-11-23 Impact factor: 0.656