Kim J C, Cho M K, Yook J W, Choe G Y, Lee I C
Department of Surgery, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea.
J Korean Med Sci. 1995 Apr;10(2):142-6. doi: 10.3346/jkms.1995.10.2.142.
A 36-year-old woman presented with a palpable tender mass at the left lower quadrant of the abdomen. She had suffered from constipation for five years and had a previous history of intrauterine device-use for one year. Preoperative barium enema and abdominopelvic CT showed a compatible finding of rectosigmoid colon cancer or left ovary cancer. She underwent segmental resection of the sigmoid colon along with the removal of left distal ureter, left ovary and salpinx. Pathologic examination revealed actinomycotic abscesses containing sulfur granules. Thereafter, she took parenteral ampicillin (50mg/kg/day) for one month and oral amoxicillin (250mg, tid) for 2 months consecutively. The patient has no specific problems for 6 months after surgical resection and long-term antibiotic therapy. This report may be the first of intrauterine device-associated pelvic actinomycosis involving both sigmoid colon and rectum extensively.
一名36岁女性因左下腹部可触及压痛性肿块就诊。她有5年便秘史，曾使用宫内节育器1年。术前钡剂灌肠和腹盆腔CT显示乙状结肠直肠癌或左卵巢癌的相符表现。她接受了乙状结肠节段性切除，同时切除了左输尿管远端、左卵巢和输卵管。病理检查发现含有硫磺颗粒的放线菌性脓肿。此后，她连续1个月接受静脉注射氨苄西林（50mg/kg/天），并连续2个月口服阿莫西林（250mg，每日3次）。手术切除和长期抗生素治疗后6个月，患者无特殊问题。本报告可能是首例宫内节育器相关的盆腔放线菌病广泛累及乙状结肠和直肠。
