Ladurner R, Bogner J R, Drosse I, Volkmer E, Sommerey S, Hohenbleicher F, Wirth S, Ozimek A, Mussack T
Department of Surgery, University of Munich (LMU), Nussbaumstrasse 20, 80336, Munich, Germany.
Hernia. 2008 Oct;12(5):549-52. doi: 10.1007/s10029-008-0344-6. Epub 2008 Apr 10.
We present the case of a 60-year-old man who presented with a left hypochondrial swelling first noticed 4 weeks prior to admission to our clinic. Based on the findings of the ultrasound and magnetic resonance imaging investigation, a tumour of uncertain origin of the abdominal wall was suspected, also involving the small bowel. The swelling, including the affected lateral and transverse oblique muscles as well as the subcutaneous tissue and the adjacent omentum majus, was completely excised. The resulting myoaponeurotic defect of the left lateral abdominal wall was closed with interrupted Vicryl sutures and stabilised with a PTFE prosthesis (20 x 10 cm) that was placed intraabdominally and secured by spiral tackers and interrupted transfascial monofilament Prolene sutures. Microscopic examination of the excised specimen revealed an actinomycosis of the anterior abdominal wall, which is extremely rare. The surgical treatment was followed by antibiotic therapy for 6 months. This treatment resulted in full recovery with no further complications.
我们报告一例60岁男性病例，该患者在入院前4周首次发现左季肋部肿胀。根据超声和磁共振成像检查结果，怀疑是腹壁来源不明的肿瘤，且累及小肠。包括受累的外侧和腹横斜肌以及皮下组织和相邻大网膜在内的肿胀物被完整切除。左侧腹壁由此产生的肌膜缺损用可吸收聚二氧六环酮缝线间断缝合，并使用一块（20×10厘米）的聚四氟乙烯假体进行加固，该假体置于腹腔内，通过螺旋钉和间断经筋膜单丝普理灵缝线固定。对切除标本的显微镜检查显示为前腹壁放线菌病，极为罕见。手术治疗后进行了6个月的抗生素治疗。该治疗使患者完全康复，未出现进一步并发症。
