title: Incarcerated umbilical hernia as the debut of abdominal actinomycosis.
abstract: BACKGROUND
  Abdominal actinomycosis is a rare infection with a difficult diagnosis that can simulate multiple surgical scenarios such as neoplasms or complications of inflammatory bowel disease.
  
  
  METHODS
  We present the case of a 69-year-old female who underwent emergency surgery due to a difficult and painful tumor, suggesting an incarcerated umbilical hernia. Whitish lesions were discovered in the abdominal wall and a stenotic colonic mass was managed similar to a neoplasm. Anatomopathological study showed abdominal actinomycosis, requiring a lengthy course with penicillin.
  
  
  CONCLUSIONS
  Actinomycosis infection is a chronic disease with granulomatous lesions and areas of fibrosis. Its incidence is increasing and the location usually is cervicofacial. The great challenge of this pathology lies in the diagnosis because it simulates different diseases of diverse natures. This type of infection can be treated successfully with drugs if the etiology is identified in a timely manner. However, in the case of our patient, the manner of presentation made diagnosis more difficult prior to surgical trauma.
authors.affiliation: Cirugía General, Hospital Universitario Reina Sofía, Córdoba, Spain. rafaorti@hotmail.com
authors.forename: Rafael José
authors.initials: RJ
authors.lastname: Orti-Rodríguez
authors.forename: Rafael
authors.initials: R
authors.lastname: Díaz-Nieto
authors.forename: Carlos Manuel
authors.initials: CM
authors.lastname: Villar-Pastor
authors.forename: Chelsy Eduvigis
authors.initials: CE
authors.lastname: Lasso-Betancor
authors.forename: Jaime
authors.initials: J
authors.lastname: Alonso-Gómez
authors.forename: Sebastián
authors.initials: S
authors.lastname: Rufián-Peña
mesh_terms: D000196:Actinomycosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003082:Colectomy; D003108:Colonic Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D003110:Colonic Neoplasms / Q000175:diagnosis; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003937:Diagnosis, Differential; D004630:Emergencies; D005260:Female; D006554:Hernia, Umbilical / Q000150:complications* / Q000601:surgery; D006801:Humans; D009852:Omentum / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D000658:Amoxicillin