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Abdominal actinomycosis presenting as a small-bowel obstruction
Matjaz Horvat1, Srecko Kovacic, Stojan Potrc
1Department of Abdominal and General Surgery, Maribor Teaching Hospital, Maribor, Slovenia. matjaz.horvat@sb-mb.si
Wiener Klinische Wochenschrift
|October 28, 2004
Summary
A rare case of abdominal actinomycosis, a bacterial infection, mimicked a tumor causing small-bowel obstruction. This condition may be linked to long-term intrauterine device (IUD) use.
Area of Science:
- Medical microbiology
- Gastroenterology
- Surgical pathology
Background:
- Abdominal actinomycosis is a rare bacterial infection caused by Actinomyces species.
- It often presents insidiously, mimicking other intra-abdominal pathologies like malignancy or inflammatory conditions.
- Intrauterine devices (IUDs) are a known risk factor for pelvic and abdominal actinomycosis.
Observation:
- A 48-year-old female presented with acute abdomen, small-bowel obstruction, and a hypogastric mass.
- Emergency laparotomy revealed a tumor-like mass compressing a small-bowel loop.
- Surgical resection included portions of the small and large bowel.
Findings:
- Pathohistological examination confirmed the mass to be abdominal actinomycosis.
- The infection's origin was suspected to be an intrauterine device (IUD) implanted nine years prior.
- This case highlights the diagnostic challenge of actinomycosis presenting as an acute abdominal emergency.
Implications:
- Actinomycosis should be considered in the differential diagnosis of abdominal masses and bowel obstructions, especially in patients with a history of IUD use.
- Early recognition and appropriate antibiotic therapy are crucial for successful management.
- This case underscores the importance of a thorough patient history, including gynecological device usage, in diagnosing rare infections.