A CASE OF ILEOCECAL ACTINOMYCOSIS WITH A REVIEW OF 170 CASES REPORTED IN JAPAN

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  • 回盲部放線菌症の１例

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Abstract

A 53-year-old woman, who complained of a mass in her right lower abdomen with tenderness, underwent laparotomy under a preoperative diagnosis of ileoceal malignant lymphoma. Histopathological examination revealed druse of actinomycosis and ileocecal actinomycosis was diagnosed. PEPC was orally administered at a dose of 2g/day for about 2 months to prevent recurrence.<br>Abdominal actinomycosis, which often forms an abdominal mass, is a chronic purulent granulomatous disease. To diagnose this disease is difficult and it is often diagnosed postoperatively by histopathological examination. We reviewed 170 reported cases of abdominal adinomycosis in Japan. The male-to-female ratio was 71:95, and a mean age of them was 51.8 years. The tumor occurs commonly in the ileocecal region, tansverse colon and pelvic cavity. The reasons why the diagnosis is so difficult are that the disease lacks specific symptom and imaging findings, and that we have often difficulty in biopsy. However, 77.8% (14 out of 18 cases) of the patients who were correctly diagnosed preoperatively were cured only by antibiotics. Patients can avoid invasive treatment if preoperative diagnosis can be made correctly. Actinomycosis should be included in the differential diagnoses for abdominal tumors.

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