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Hayashi M, Asakuma M, Tsunemi S, Inoue Y, Shimizu T, Komeda K, Hirokawa F, Takeshita A, Egashira Y, Tanigawa N. Surgical treatment for abdominal actinomycosis: A report of two cases. World J Gastrointest Surg 2010; 2(12): 405-408 [PMID: 21206723 DOI: 10.4240/wjgs.v2.i12.405]
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.
