大網原発腹部放線菌症の1例

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  • A CASE OF ABDOMINAL ACTINOMYCOSIS ORGINATED IN THE GREATER OMENTUM

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An extremely rare case of abdominal Actinomycosis originated in the greater omentum was experienced. The case involved a 68-year-old woman with diabetes mellitus. She was seen at the hospital because of a palpable abdominal mass preceded by abdominal pain. Characteristic features of the mass included hardness, tenderness, and poor movability. The white blood cell count was within normal range. After admission abdominal CT revealed a mass 6cm in diameter just under the abdominal wall of the right lower abdomen which was poorly-defined at the wall-side; and visualized a thickened abdominal wall, from which direct invasion was suspected. On the other hand the deepest portion was smooth, and there was a cavity in the mass with a protrusion mimicking an intramural tumor. Abdominal ultrasonography showed a hypoechoic and intrenally heterogenous tumor with cystic structure partially. It was difficult to rule out a possibility of malignant tumor, because abdominal findings were slight, leukocytosis was lacked, no response was attained by administration of antibiotics, the tumor tended to increase, and CT findings indicated an invasive growth into the abdominal wall. Operation was carried out. The removed specimen was a 7×7 ×5cm solid tumor comprizing of the greater omentum and rectus abdominis muscle including a tumorous tissue. It was granuloma with yellow-green pus. Actinomycosis was determined pathologically by the findings of sulfur granule. The patient was diagnosed as abdominal Actinomycosis originated in the greater ometum.

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