Lim Kyoung Hoon, Kim Jang Ho, Jeong Ji Yun
Department of Surgery, Andong General Hospital, Andong, Republic of Korea.
Surg Laparosc Endosc Percutan Tech. 2011 Oct;21(5):e288-90. doi: 10.1097/SLE.0b013e31823032d1.
Omental actinomycosis without any predisposing factors is rare, and there are few reports on it invading the contiguous bowels to form fistulae. We describe the case of a 55-year-old male patient with omental actinomycosis that presented as an inflammatory tumor that formed fistulae with the transverse colon and upper jejunum. On admission, he had complaints of a palpable, tender mass on the left mid-abdomen without gastrointestinal symptoms. After 7 days of conservative treatments (NPO and intravenous antibiotics), the size of the mass was decreased and tenderness was more improved. Laparoscopic resected omental mass revealed fistulae to the colon and jejunum. There was no evidence of Crohn disease. After 1-week use of antibiotics owing to the concern about actinomycosis, the mass was decreased and it was more amenable to dissect laparoscopically.
无任何诱发因素的网膜放线菌病较为罕见，关于其侵犯相邻肠管形成瘘管的报道也很少。我们描述了一例55岁男性网膜放线菌病患者，表现为炎性肿瘤，并与横结肠和空肠上段形成瘘管。入院时，他主诉左中腹可触及压痛性肿块，无胃肠道症状。经过7天的保守治疗（禁食和静脉使用抗生素），肿块大小减小，压痛更有改善。腹腔镜切除的网膜肿块显示与结肠和空肠有瘘管。没有克罗恩病的证据。由于担心放线菌病，使用抗生素1周后，肿块减小，更便于腹腔镜下分离。
