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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Mesenteric or retroperitoneal actinomycosis is an extremely rare disease. The international databases have revealed only 10 cases affecting the mesenterium and another 52 cases affecting the retroperitoneum. We report a 78-year-old female who was admitted with complaints of abdominal pain. Laboratory examination revealed anemia and the clinical examination revealed an irregular mass in the abdomen. Ultrasound and computed tomography (CT) scans showed a solid mass in the mesenteric-retroperitoneal region. Biopsy of the nonresectable mass revealed the presence of chronic inflammation in the mesenteric area with Actinomyces colonies. The patient was treated with oral amoxicillin, 500 mg every 6 hours for 6 months. The symptoms disappeared, but the mesenteric-retroperitoneal mass remains, but smaller in size. Based on the review of the literature and the case reported here, we conclude that mesenteric-retroperitoneal actinomycosis is difficult to diagnose by means of noninvasive techniques as it can masquerade as a malignant process. An accurate diagnosis is always obtained in a histological or microbiological examination, often requiring surgical intervention. Treatment with penicillin has proven to be effective.
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PMID:Mesenteric actinomycosis with retroperitoneal involvement. 1189 Mar 42

A 34-y-old African-American male developed Actinomyces liver abscess 8 months after appendectomy. Review of the English language literature revealed 56 additional cases of hepatic actinomycosis. Affected patients were typically immunocompetent, had a wide age range (4-86 y) and were predominantly male (70.2%). Infection was frequently (80.7%) cryptogenic, presenting with fever (83.3%), abdominal pain (74.5%) and weight loss (50.9%) over a 3.7 +/- 5.1 month period. The most common radiographic finding was a single hypodense mass/abscess (68.4%). Extension to surrounding tissues was evident in 19 cases (33.3%). Diagnosis was usually accomplished microscopically and culture was often (33.3%) negative. Infection was often (35.2%) mixed, usually with anaerobic bacteria. A surgical or percutaneous approach was diagnostic in 29/35 (82.9%) and 24/33 (72.7%) cases, respectively. The overall mortality rate was 8.8%; it was 10.7% with medical therapy alone and 4.0% using a combined medical/intervention approach (p = 0.6). In conclusion, hepatic actinomycosis is a rare subacute infection that may mimic neoplasm. It is usually cryptogenic, is more common among immunocompetent individuals and male subjects and is highly responsive to medical therapy.
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PMID:Hepatic actinomycosis: an overview of salient features and outcome of therapy. 1206 27

We report herein a rare case of ureteral and sigmoid obstruction caused by pelvic actinomycosis in a patient fitted with an intrauterine contraceptive device (IUCD). A 63-year-old Japanese woman was admitted complaining of lower abdominal pain and slight fever continuing for a month. She had a history of IUCD insertion 30 years previously and had been menopausal for the past 10 years. Ultrasonography and CT scan revealed a solid pelvic mass involving the uterus, sigmoid colon, urinary bladder, and right ureter. The IUCD was detected in the uterine cavity. Right hydronephrosis and hydroureter due to an obstruction of the distal ureter and the extensive stenosis of the sigmoid colon were also observed. Blood analysis showed leukocytosis, thrombocytosis, and elevated C-reactive protein levels. Although pathological and microbiological analysis of the removed IUCD showed negative results for Actinomyces infection, these findings suggested a pelvic abscess caused by actinomycosis. Benzyl penicillin administration was started immediately. Total hysterectomy, bilateral salpingo-oophorectomy, and lysis of adhesion around the ureter were performed. Actinomycosis was diagnosed based on histologic examination. The patient's postoperative course was uneventful except for persistent mild hydroureter and hydronephrosis. The patient is now healthy without evidence of recurrent Actinomyces infection 1 year after treatment. As shown in the present case, pelvic actinomycosis should be considered as a cause of pelvic inflammatory disease in IUCD users, even though Actinomyces was not detected on the IUCD.
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PMID:Ureteral and sigmoid obstruction caused by pelvic actinomycosis in an intrauterine contraceptive device user. 1259 67

Two women, aged 50 and 45 years, had a chronic process in the lower abdomen. The first presented with cough and progressive dyspnoea, and her chest X-ray raised the suspicion of a metastasis of a malignancy. The second patient had abdominal pain, frequent urination and irregular vaginal bleeding. She was initially treated for a urinary-tract infection. Diagnostic investigations showed pelvic actinomycosis in both patients. Both had used an intrauterine device (IUD). In the first patient a pelvic abscess was drained. Antimicrobial treatment consisted of penicillin i.v. for several weeks and orally for 6 months. Actinomycosis is a slowly progressive bacterial infection that characteristically expands through anatomic structures and can lead to fistulae and abscesses. The disease is caused by Actinomyces species. Diagnosis is often delayed because other diseases (e.g. malignancy) are considered more probable. Actinomycosis is associated with prolonged use of an IUD, but it is rare and removal of the IUD is not indicated unless symptoms of pelvic inflammatory disease are present. The mainstay of actinomycosis therapy is administration of an effective antibiotic (e.g. penicillin). Except for drainage of abscesses, surgical intervention is rarely necessary. When antimicrobial therapy is continued for 6-9 months, prognosis is favourable, as was the case in both patients.
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PMID:[Two women with a chronic process in the lower abdomen]. 1467 81

A 55-year-old woman had complained of lower abdominal pain for 5 years. A computed tomographic CT scan and magnetic resonance imaging revealed a heterogeneous density mass on the left side of the bladder. CT-guided needle biopsy showed only inflammatory cell infiltration without histological diagnosis. To confirm the diagnosis, the mass was resected together with part of the bladder and peritoneum. On the cut surface, the mass was centrally pale yellow and adherent to the thickened hard wall of the bladder and peritoneum. Pathological diagnosis was chronic granulomatous inflammation with actinomycosis. This is, to our knowledge, the 12th case report of vesical actinomycosis in Japan. Although actinomycosis is very rare in urological field, abdominal actinomycosis should be considered as the differential diagnosis of any inflammatory abdominal mass.
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PMID:[Vesical actinomycosis: a case report]. 1471 53

We present the case of an elderly patient with abdominal pain, weight loss, and subjective fever in whom a magnetic resonance imaging study revealed a perihepatic abscess without invasion. After drainage, anaerobic cultures yielded Actinomycosis israelii. We discuss Actinomycosis species, with an emphasis on its pathology and multiple presentations.
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PMID:Actinomycotic tumor of the abdominal wall. 1498 69

A 51-year-old male with a clinical history of abdominal pain and bloody diarrhea underwent spiral computed tomography of the abdomen with intravenous contrast medium enhancement. The findings were an inflammatory mass with cystic and solid characteristics arising from the ileocecal region and extending to the peritoneum and right iliopsoas muscle, with adjacent lymphadenopathy. Histology after surgical resection confirmed the diagnosis of actinomycosis lesions in perienteric fat.
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PMID:Ileocecal actinomycosis: a case report. 1516 Jul 50

Pelvic actinomycosis is a chronic granulomatous suppurative disease caused by an anaerobic gram-positive organism Actinomyces israelii usually associated with intrauterine devices. Systemic lupus erythematosus is an autoimmune disorder associated with multiple primary and drug-related immunological defects that predispose patients to infections. The combination of both diseases in a postmenopausal patient is a rare occurrence. A case of a pelvic mass in a 49-year-old postmenopausal patient with systemic lupus erythematosus treated with immunosuppressive therapy for two years is presented. The patient presented with lower abdominal pain to the gynecology clinic and was found to have a pelvic tumor. She had no history of intrauterine device use. Histopathologic examination of the laparotomy specimen revealed pelvic actinomycosis.
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PMID:Pelvic actinomycosis in a postmenopausal patient with systemic lupus erythematosus mimicking ovarian malignancy: case report and review of the literature. 1526 77

Hepatic actinomycosis is an uncommon entity that forms communicating abscesses and fistulae. We report a 53-y-old immunocompetent male patient with hepatic actinomycosis. Symptoms included intermittent fever, abdominal pain, right upper quadrant tenderness and jaundice. A hepatic tumour mass was found on abdominal sonography and computerized tomography. Two preoperative percutaneous core biopsies of the mass were not diagnostic. The above findings were highly suggestive for liver abscess or purulent primary liver neoplasm. Treatment with intravenous antibiotics was continued for 20 d, but both symptoms and liver ultrasound findings remained unchanged. The patient underwent exploratory laparotomy and right posterior segmentectomy of the liver. Pathological examination of the surgically removed specimen disclosed hepatic actinomycosis. Following operation the patient remains in excellent condition without evidence of recurrence.
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PMID:Liver resection in cases of isolated hepatic actinomycosis: case report and review of the literature. 1530 97

We present a case of a 58 year old white male who entered the hospital with abdominal pain and developed large bowel obstruction, simulating malignant disease. Anatomopathological examination showed abdominal actinomycosis, a rare presentation of this disease.
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PMID:Actinomycosis simulating malignant large bowel obstruction. 1536 99


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