Ozcan Rahsan, Mammadov Emil, Aydin Emrah, Adaletli Ibrahim, Esen Tugçe, Dervisoglu Sergülen, Celayir Sinan
Istanbul University, Cerrahpasa Medical Faculty, Departments of Pediatric Surgery Istanbul, Turkey.
APSP J Case Rep. 2011 Jan;2(1):4. Epub 2011 Mar 10.
Abdominal actinomycosis in childhood period is very rare and a relation to trauma is not well established. Herein we report a case that appeared subsequent to abdominal trauma. A 17 years old boy presented with left lower quadrant abdominal mass and signs of acute abdomen. The symptoms of abdominal discomfort began after a fall from height 3 months before admission. There were signs of acute abdomen at physical examination. Ultrasound of abdomen demonstrated a mass; CT scan findings pointed to a suspicious "internal hernia". An emergency laparotomy was performed. During surgery, a mass located over sigmoid colon and infiltrating the lateral abdominal wall was found. It was removed en bloc with the adjacent omentum. Except for the thickened sigmoid colon, no other pathologies were present at laparotomy. The pathology specimen revealed the actinomyces infection. The patient was treated with oral penicillin after discharge and the follow-up was uneventful. We advocate, keeping the actinomyces infection in mind in cases presenting with abdominal mass of unknown origin in childhood period.
儿童期腹部放线菌病非常罕见,与创伤的关系尚不明确。在此我们报告一例腹部创伤后出现的病例。一名17岁男孩因左下腹肿块及急腹症体征就诊。入院前3个月从高处坠落之后开始出现腹部不适症状。体格检查有急腹症体征。腹部超声显示有一肿块;CT扫描结果提示可疑“内疝”。遂行急诊剖腹探查术。术中发现一个位于乙状结肠上方并浸润侧腹壁的肿块。将其与相邻大网膜一并整块切除。剖腹探查时除乙状结肠增厚外,未发现其他病变。病理标本显示为放线菌感染。患者出院后接受口服青霉素治疗,随访情况良好。我们主张,对于儿童期出现不明原因腹部肿块的病例应考虑到放线菌感染。