Case Report
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World J Gastrointest Surg. Dec 27, 2010; 2(12): 405-408
Published online Dec 27, 2010. doi: 10.4240/wjgs.v2.i12.405
Surgical treatment for abdominal actinomycosis: A report of two cases
Michihiro Hayashi, Mitsuhiro Asakuma, Soichiro Tsunemi, Yoshihiro Inoue, Tetsunosuke Shimizu, Koji Komeda, Fumitoshi Hirokawa, Atsushi Takeshita, Yutaro Egashira, Nobuhiko Tanigawa
Michihiro Hayashi, Mitsuhiro Asakuma, Soichiro Tsunemi, Yoshihiro Inoue, Tetsunosuke Shimizu, Koji Komeda, Fumitoshi Hirokawa, Atsushi Takeshita, Yutaro Egashira, Nobuhiko Tanigawa, Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686, Japan
Author contributions: Hayashi M designed the research; Hayashi M, Asakuma M, Tsunemi S, Inoue Y, Shimizu T, Komeda K, Hirokawa F, Takeshita A, Egashira Y and Tanigawa N performed the research; Hayashi M and Asakuma M analyzed the data; Hayashi M and Asakuma M wrote the paper.
Correspondence to: Michihiro Hayashi, MD, Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686, Japan. sur083@poh.osaka-med.ac.jp
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Received: June 5, 2010
Revised: September 19, 2010
Accepted: September 26, 2010
Published online: December 27, 2010
Abstract

Since actinomycosis sometimes causes an abdominal tumor which mimics malignancy, treatment strategy varies from case to case. We herein report two cases which were treated with a combination of antibiotics and surgical intervention. Both patients presented with an intra-abdominal tumor lesion mimicking malignant disease after an appendectomy for acute appendicitis. Case 1 received surgical extirpation of the abdominal tumor in the liver and kidney twice since the clinical diagnosis of actinomycosis was not made. In contrast, case 2 was successfully treated by a combination of antibiotics and laparoscopic surgery following the experience of case 1. When a high probability diagnosis can be made, a laparoscopic approach is a useful and effective option to treat this condition.

Keywords: Abdominal actinomycosis; Surgical therapy; Laparoscopic surgery; Single port surgery