Balakrishnan Malathy, Phan Yih Chyn, McIlroy Brendan, Leung Edmund
County Hospital Hereford, Hereford, UK.
College of Medicine and Veterinary Medicine, Edinburgh Medical school, The University of Edinburgh, Edinburgh, UK.
BMJ Case Rep. 2019 Feb 25;12(2):e227876. doi: 10.1136/bcr-2018-227876.
A fit and healthy 26-year-old woman presented to the general surgical team with epigastric pain and weight loss of 2 stones over 6 months. She has also a positive family history of ulcerative colitis. As her oesophagogastroduodenoscopy and colonoscopy were normal, a contrasted CT was requested, and it detected an inflammatory mass with fat streaking around her transverse colon. An intrauterine contraceptive device (IUCD) was noted. In light of the CT findings, she underwent a diagnostic laparoscopy. As the inflammatory mass was not separable from the transverse colon, a segmental transverse colectomy was proceeded. The histology revealed multiple actinomycosis abscesses in the mesentery. Subsequently, we learnt that her IUCD had been in situ for the last 7 years, and the source of actinomycosis abscesses is likely from her IUCD. The patient was recommended to have the coil removed and commenced on a 6 months course of amoxicillin.
一名身体健康的26岁女性因上腹部疼痛和6个月内体重减轻2英石就诊于普通外科团队。她还有溃疡性结肠炎的家族史。由于她的食管胃十二指肠镜检查和结肠镜检查均正常，于是进行了增强CT检查，结果发现其横结肠周围有一个伴有脂肪条纹的炎性肿块。还发现了一个宫内节育器（IUCD）。根据CT检查结果，她接受了诊断性腹腔镜检查。由于炎性肿块与横结肠无法分离，遂进行了节段性横结肠切除术。组织学检查显示肠系膜中有多个放线菌脓肿。随后，我们了解到她的宫内节育器已在位7年，放线菌脓肿的来源很可能是她的宫内节育器。建议患者取出节育器，并开始服用阿莫西林，疗程为6个月。
