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[腹壁放线菌病。一例报告]

[Abdominal wall actinomycosis. A report of a case].

作者信息

Rojas Pérez-Ezquerra Beatriz, Guardia-Dodorico Lorena, Arribas-Marco Teresa, Ania-Lahuerta Aldonza, González Ballano Isabel, Chipana-Salinas Margot, Carazo-Hernández Belén

机构信息

Servicio de Ginecología, Hospital de Barbastro, Huesca, España.

Servicio de Ginecología, Hospital de Barbastro, Huesca, España.

出版信息

Cir Cir. 2015 Mar-Apr;83(2):141-5. doi: 10.1016/j.circir.2015.04.010. Epub 2015 May 16.

Abstract

BACKGROUND

Abdominal wall Actinomycosis is a rare disease associated with the use of intrauterine device and as a complication of abdominal surgery. Diagnosis is difficult because it is unusual and behaves like a malignant neoplasm.

AIM

A case report is presented of a patient who had used an intrauterine device for four years and developed a stony tumour in the abdominal wall associated with a set of symptoms that, clinically and radiologically, was simulating a peritoneal carcinomatosis associated with paraneoplastic syndrome, even in the course of an exploratory laparotomy.

CLINICAL CASE

The patient attended our hospital with a two-month history of abdominal pain and symptoms that mimic a paraneoplastic syndrome. The diagnosis of abdominal actinomycosis was suspected by the finding of the microorganism in cervical cytology together with other cultures and Actinomyces negative in pathological studies, confirming the suspicion of a complete cure with empirical treatment with penicillin.

CONCLUSIONS

Actinomycosis should be considered in patients with pelvic mass or abdominal wall mass that mimics a malignancy. Antibiotic therapy is the first treatment choice and makes a more invasive surgical management unnecessary.

摘要

背景

腹壁放线菌病是一种罕见疾病,与宫内节育器的使用有关,也是腹部手术的一种并发症。由于其不常见且表现类似恶性肿瘤,诊断较为困难。

目的

本文报告一例患者,该患者使用宫内节育器四年后,腹壁出现坚硬肿物,并伴有一系列症状,这些症状在临床和放射学上模拟了伴有副肿瘤综合征的腹膜癌,甚至在剖腹探查术中也是如此。

临床病例

该患者因腹痛两个月及类似副肿瘤综合征的症状前来我院就诊。通过在宫颈细胞学检查中发现该微生物,以及其他培养结果和病理研究中放线菌呈阴性,怀疑为腹壁放线菌病,经青霉素经验性治疗证实诊断并实现完全治愈。

结论

对于出现类似恶性肿瘤的盆腔肿物或腹壁肿物的患者,应考虑放线菌病。抗生素治疗是首选治疗方法,无需进行更具侵入性的手术治疗。

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