[Actinomycosis of the small intestine--an unusual cause of acute abdomen].
Actinomycosis is subacute or chronic disease manifested by a defined granulomatous inflammation with the development of infiltrates, abscesses and fistulae. A 35-year-old female patient was admitted and operated at the Second Surgical Clinic because of symptoms of diffuse peritonitis. Laparotomy revealed a duplicit tumour of the small intestine, an abscess of the abdominal wall in the left mesogastrium and pyoovarium bilaterale. 70 cm of the small intestine were resected, incision of the abscess and bilateral adnexotomy were performed. Histological examination revealed a suppurative, partly fibroproductive inflammation with an actinomycotic etiopathology. After antibiotic treatment the patient was discharged home, the gynaecologist removed an intrauterine device. Three months after the first operation the patient in a serious septic condition was readmitted to the clinic with signs of diffuse peritonitis. A double perforation of the small intestine was found and an end-to-end anastomosis was made after resection of the small intestine. The postoperative course was complicated by respiratory failure and failure of the circulation associated with septic shock and subsequent death. In the conclusion the authors emphasize the problem of preoperative diagnosis of the abdominal form of actinomycosis, its possible development in relation to intrauterine contraceptive devices and its clinical manifestation as acute abdomen.
Belák
J
J
II. chirurgická klinika FN L. Pasteura, LF UPJS, Kosice, Slovenská republika.
Vajó
J
J
Böör
A
A
Simon
R
R
Kudlác
M
M
Mad'ar
M
M
Balunová
E
E
Stebnický
M
M
D000006:Abdomen, Acute / Q000209:etiology*; D018784:Abdominal Abscess / Q000209:etiology / Q000601:surgery; D000196:Actinomycosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D000328:Adult; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery