Actinomycosis of Sigmoid Colon Caused by the Penetration of Swallowed Fish Bone -Report of a Case-

Akira Tsuburaya, Yoshikazu Noguchi, Yoshinori Kure, Tomisige Amano, Akihiko Matsumoto, Haruo Sekino*, Kunihiko Masukawa*, Kazuhiro Horiguchi*

First Department of Surgery, Yokohama City University School of Medicine
*Department of Surgery, Ashigara Kami Hospital

A rare case of actinomycosis caused by fish bone induced perforation of the sigmoid colon is presented. A 60-year-old male patient was admitted because of fever and an abdominal mass. On physical examination, a fist-sized, hardly movable, and tender mass was palpated at the right lower abdomen. Barium enema showed segmental narrowing and a longitudinal ulcer scar at the sigmoid colon, although its mucosal surface was relatively smooth. Computed tomography and ultrasonography revealed a 6-cm diameter irregularly marginated, heterogenous intrapelvic mass, which was poorly demarcated from adjacent sigmoid colon, bladder and peritoneum. Tumor size and pain decreased after chemotherapy. It was suspected to be an inflammatory mass, however the possibility of malignancy was not ignored. Resection of the tumor and sigmoid colon was performed. The tumor was found to be a granuloma at the sigmoid mesocolon and contained pus and a piece of fish bone, 2.5 cm in size, in its center. Histological examination revealed sulfur granules specific to actinomyces in the abscess.

Key words
fish bone penetration of gastrointestinal tract, actinomycosis

Reprint requests
Akira Tsuburaya First Department of Surgery, Yokohama City University School of Medicine
3-46 Urafune-cho, Minami-ku, Yokohama, 232 JAPAN

Accepted
November 19, 1990

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