Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 7 , ISSUE 2 ( May-August, 2018 ) > List of Articles

CASE REPORT

Disseminated Abdominal Actinomycosis: An Unusual Cause of Obstruction

Cristina M Álvarez,, José O Martínez,, Mónica G Noriega, Enrique T Martínez, Federico C Suescun, Roberto F Santiago, Juan C R Sanjuan, Patrizio Petrone

Keywords : Abdominal presentation, Actinomycosis, Bowel obstruction

Citation Information : Álvarez, CM, Martínez, JO, G Noriega M, Martínez ET, Suescun FC, Santiago RF, Sanjuan JC, Petrone P. Disseminated Abdominal Actinomycosis: An Unusual Cause of Obstruction. Panam J Trauma Crit Care Emerg Surg 2018; 7 (2):164-166.

DOI: 10.5005/jp-journals-10030-1219

License: CC BY-NC 4.0

Published Online: 01-08-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: Actinomycosis is an uncommon diagnosis, involving the abdominal cavity in around 20% of cases. It is characterized by its tendency to form masses and abscesses that, added to its subacute onset, can be difficult to differentiate from other conditions. Obstruction is rare but is mainly associated with the presence of an abnormal growth of tissue as mimicking a malignancy. Pelvic forms are usually related to prolonged use of intrauterine devices, although other causes within mucosal disruption have been described. Case report: A 36-year-old woman with type 1 diabetes mellitus and diabetic nephropathy who underwent pancreas-kidney transplantation, with no incidences during the surgical procedure. She developed fever, which did not disappear despite drainage of abdominal fluid collections. Subsequently, she developed abdominal obstructive symptoms requiring urgent surgery. During the exploratory laparotomy, numerous small white formations were identified scattered throughout the entire abdominal cavity, causing firm adhesions between bowels. During the procedure, biopsies were taken and adhesiolysis was performed. Conclusion: Abdominal actinomycosis must be considered not just in the presence of fever and weight loss but also must be rule out in unusual onsets such as small bowel obstruction. To our knowledge this presentation as disseminated lesions has not been described in the literature.


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  1. Gómez-Torres GA, Ortega-Gárcia OS, Gutierrez-López EG, Carballido-Murguía CA, et al. A rare case of subacute appendicitis, actinomycosis as the final pathology reports: A case report and literature review. Int J Surg Case Rep 2017;36:46-49.
  2. Choi M, Jeong HB, Jung NL, Sanghui P, Lee W. Clinical features of abdominopelvic actinomycosis: Report of twenty cases and literature review. Yonsei Med J 2009;50(4):555-559.
  3. Bonnefond S, Catroux M, Melenotte C, Karkowski L, et al. Clinical features of actinomycosis A retrospective, multicenter study of 28 cases of miscellaneous presentations. Medicine (Baltimore) 2016;95(24)e3923.
  4. Acevedo F, Baudrand R, Letelier LM, Gaete P. Actinomycosis: a great pretender. Case reports of unusual presentations and a review of the literature. Int J Infect Dis 2008;12(4): 358-362.
  5. Pusiol T, Morichetti D, Pedrazzani C, Ricci F. Abdominalpelvic actinomycosis mimicking malignant neoplasm. Infect Dis Obstet Gynecol 2011;2011:747059. Published online 2011 Aug 29.
  6. Hildyard CAT, Gallacher NJ, Macklin PS. Abdominopelvic actinomycosis mimicking disseminated peritoneal carcinomatosis. BMJ Case Rep 2013. (nov21_1) pii: bcr2013201128
  7. Karagulle E, Turan H, Turk E, Kiyici H, Yildirim E, Moray G. Abdominal actinomycosis mimicking acute appendicitis. Can J Surg 2008;51(5):E109-E110.
  8. Sung HY, Lee IS, Kim SI, Jung SE, Kim SW, Kim SY, et al. Clinical features of abdominal actinomycosis: A 15-year experience of a single institute. J Korean Med Sci 2011;26(7):932-937.
  9. Heidt J, Jansen CL, Leyten EMS. An abdominal mass: Not a ‘clear cut’ case! Neth J Med 2010;68(10):319-321.
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