Noomene F, Zouari K, Kallel W, Nasr M, Ketata M, Hamdi A
Service de chirurgie générale et digestive EPS F. Bourguiba Monastir 5000 Tunisie.
Presse Med. 2003 Apr 26;32(15):698-700.
Abdominal actinomycosis is a suppurating affection caused by a positive Gram germ, Actinomyces israelii. Manifestations of this rare disease are usually pseudotumoral syndromes leading to surgical exeresis. The diagnosis is obtained from the histologic report.
We report three cases in all of which this disease presents with tumoral symptoms. The first affected the sigmoïd, the second affected the mesentery and the last affected the greater omentum and abdominal wall. In no case, the diagnosis was done before surgery. In 2 of the cases reported here, the patients had an old, incontrolled intra-uterine device.
From a review of the literature, we observed that the diagnosis of abdominal actinomycosis remains difficult. The radiologic findings are nonspecific. Actinomycosis is treated with prolonged antibiotics, and surgery is only needed in abdominal abscess and fistula.
Theses observations illustrates the difficulties of the diagnosis of this rare unrecognized disease.
腹部放线菌病是由革兰氏阳性菌以色列放线菌引起的化脓性疾病。这种罕见疾病的表现通常为假瘤综合征，需进行手术切除。诊断需依据组织学报告。
我们报告了三例该疾病均表现为肿瘤症状的病例。第一例累及乙状结肠，第二例累及肠系膜，最后一例累及大网膜和腹壁。所有病例均在手术前未确诊。在此报告的2例病例中，患者体内有陈旧的、未取出的宫内节育器。
通过对文献的回顾，我们发现腹部放线菌病的诊断仍然困难。影像学表现不具有特异性。放线菌病采用长期抗生素治疗，仅在腹部脓肿和瘘管形成时需要手术治疗。
这些观察结果说明了诊断这种罕见的未被认识疾病的困难之处。
