Yonsei Med J.  2006 Aug;47(4):583-586. 10.3349/ymj.2006.47.4.583.

Abdominal Actinomycosis Associated with a Sigmoid Colon Perforation in a Patient with a Ventriculoperitoneal Shunt

• Jung EY
• Choi SN
• Park DJ
• You JJ
• Kim HJ
• Chang SH

• KMID: 1779512
• DOI: http://doi.org/10.3349/ymj.2006.47.4.583

Abstract

Abdominal actinomycosis causing hydronephrosis in a patient with a ventriculoperitoneal shunt is very rare. A 27- year-old female patient was admitted complaining of lower abdominal pain. She had undergone ventriculoperitoneal shunt surgery 10 years ago. Abdominal Ultrasonography and a CT scan demonstrated an inflammatory mass in the lower left quadrant of the abdomen causing obstructive hydroureter and hydronephrosis. Laparotomy revealed a diffusely infiltrating mass involving the small bowel, mesentery, and sigmoid colon, and a 1cm perforation in the sigmoid colon. Actinomycosis was diagnosed upon histological examination. After treatment with antibiotics and surgery, the patient's condition improved.

Keyword

Actinomycosis; hydronephrosis; ventriculoperitoneal shunt

MeSH Terms

Ventriculoperitoneal Shunt
Ultrasonography
Treatment Outcome
Tomography, X-Ray Computed
Intestinal Perforation/*diagnosis
Inflammation
Humans
Female
Colon, Sigmoid/*injuries/*pathology
Adult
Actinomycosis/*diagnosis
Abdominal Pain

Figure

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  Fig. 1 (A) Abdominal computed tomography (CT) shows left hydroureter and hydronephrosis. VP shunt is shown (white arrow). (B) The approximately 6 × 7 cm multilobulated, poorly-margined mass in the lower left quadrant encases left ureter (white arrow).

• 

  Fig. 2 Sigmoid colon is thickened and perforated about 1 cm in diameter.

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  Fig. 3 Histological examination of the resected tissue shows the sulfur granules characteristic of actinomycosis (H&E, ×400).

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