Abdominopelvic actinomycosis associated with an intrauterine device and presenting with a rectal mass and hydronephrosis: A troublesome condition for the clinician
International Surgery, cilt.97, sa.3, ss.254-259, 2012 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 97 Sayı: 3
- Basım Tarihi: 2012
- Doi Numarası: 10.9738/cc121.1
- Dergi Adı: International Surgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.254-259
- Anahtar Kelimeler: Abdominopelvic actinomycosis, Hydronephrosis, Intrauterine device, Rectum, Tuboovarian structure
- Gazi Üniversitesi Adresli: Hayır
Özet
Actinomycosis is an uncommon, chronic, granulomatous disease that can be mistaken for a malignant tumor. Abdominopelvic actinomycosis constitutes about 20% of all actinomycosis cases and may mimic malignancy, tuberculosis, or other abdominopelvic inflammatory diseases. This condition is more prevalent in women who use an intrauterine device. We treated a 44-year-old woman who presented with vaginal discharge, right flank pain, dysuria, and difficulty with defecation. She had anorexia and weight loss (8 kg) during the previous 2 months and had a history of intrauterine device use for 12 years. Clinical, radiologic, and endoscopic examinations revealed a rectal mass and right hydronephrosis. Rectal biopsy showed nonspecific colitis. Laparotomy showed a mass that was invading and obstructing the pelvic orifice. Surgery included total abdominal hysterectomy, bilateral salpingo-oophorectomy, appendectomy, low anterior resection, and Hartmann colostomy. Histopathologic evaluation of surgical specimens showed actinomycosis originating from the tubo-ovarian structures and invading the rectal wall. The patient was placed on penicillin for 6 months, and then had closure of the colostomy with no complication.