A Case of Actinomycosis of the Sigmoid Colon Associated with Non-rotation of the Midgut in Adult

Takuro Saito, Takao Tsuchiya, Michihiko Kogure, Yukio Endo, Hiroyuki Suzuki, Tsuyoshi Abe, Hitoshi Inoue, Ryouichi Motoki

The First Department of Surgery, Fukushima Medical College

A case of actinomycosis of the sigmoid colon associated with non-rotation of the midgut in adult is reported. A 54-year-old woman was admitted to our hospital complaining of left lower quadrant pain and severe constipation. There was a slightly tender, firm, fixed mass in the left lower quadrant. A barium enema and colonofiberoscopy revealed an illdefined filling lesion and nodular elevated mucosa in the sigmoid colon. A CT scan of that area showed thickening of the colon wall involving its entire circumference. Thus, we were unable to determine whether the lesion was carcinomatous or inflammatory preoperatively. At surgery, we discovered that this case was complicated by a midgut anomaly of the non-rotation type. A large tumor mass was located in the wall of sigmoid colon, and was accompanied by a lesion of the ileocecal area and transverse colon. Resection of the ileocecal lesion via the sigmoid colon and ileostomy were performed. Histologically, the lesion revealed non-specific inflammation with fibrosis. There were many small, scattered abscesses and irreguler colonies of actinomyces (sulfur granules) were found within them.

Key words
actinomycosis of the sigmoid colon, non-rotation of the midgut in adult

Reprint requests
Takuro Saito First Department of Surgery, Fukushima Medical College
1 Hikarigaoka, Fukushima-shi, 960-12 JAPAN

Accepted
April 1, 1992

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