Abdominopelvic actinomycosis: spectrum of imaging findings and common mimickers
نویسندگان
چکیده
BACKGROUND Actinomycosis is a rare suppurative disease that may mimic other inflammatory conditions on imaging. Its invasive nature may lead to mass formation and atypical presentation thus making accurate diagnosis quite difficult. PURPOSE To describe the different aspects of abdominopelvic actinomycosis on cross-sectional imaging and indicate discriminative findings from other inflammatory or neoplastic diseases. MATERIAL AND METHODS In our study we analyzed 18 patients (15 women, 3 men; age range, 25-75 years; mean age, 50 years) with pathologically proved abdominopelvic actinomycosis. Contrast-enhanced abdominal computed tomography (CT) had been performed in all patients. Eleven patients had a history of using intrauterine contraceptive devices. Bowel site, wall thickness and enhancement degree, inflammatory infiltration, and features of peritoneal or pelvic mass were evaluated at CT. RESULTS The sigmoid colon was most commonly involved. Most patients showed concentric bowel wall-thickening, enhancing homogenously and inflammatory infiltration of pericolonic fat was mostly diffuse. In 11 patients, one or more pelvic abscesses were revealed, while a peritoneal or pelvic mass adjacent to the involved bowel segment was seen in three cases. Infiltration into the abdominal wall was seen in three cases while in one case there was thoracic dissemination. CONCLUSION Actinomycosis is related not only to long-term use of intrauterine contraceptive devices and should be included in the differential diagnosis when cross-sectional imaging studies show concentric bowel wall-thickening, intense contrast enhancement, regional pelvic or peritoneal masses, and extensive inflammatory fat infiltration with abscess formation.
منابع مشابه
Thrombocytosis and small bowel perforation: unusual presentation of abdominopelvic actinomycosis.
Intrauterine devices (IUD) are frequently used as a family planning procedure in developing countries because they are easy to administer and governmental policies support their use in many countries. It is recommended that IUDs be removed or replaced after 10 years, but longer use is common, especially in developing countries. In some cases, rare infections such as pelvic inflammatory diseases...
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Pelvic actinomycosis is an uncommon chronic granulomatous disease that is caused by actinomycosis Israeli. The most risk factor is long-term use of IUD. In this article we dealt with a 42 year old woman, who referred to the hospital with a history of intrauterine device (IUD) use for 15 years, having nonspecific lower abdominal pain, low grade fever, and occasional chills for 2 months, On pelvi...
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