A Case of Transverse Colon Actinomycosis Detected by a Painless Abdominal Tumor

Satoshi Inaba, Toshihide Arai, Hidehiko Yabuki, Hidenori Karasaki, Ichirou Tomita, Yasuhisa Kino, Mitsuhiro Obara and Teiko Sato^*

Department of Surgery, Engaru Kousei Hospital, ^*Department of Pathology, Asahikawa Kousei Hospital

A case of actinomycosis of the transverse colon was reported. A 72-year-old woman admitted to our hospital for general fatigue and loss of appetite, was found to have a fist-sized hard, non-tender tumor in the left lower abdominal quadrant. Leucocytes, thrombocytes and CRP were within normal ranges. Abdominal computed tomography (CT) showed a edematous nonhomogeneous enhanced tumor adhering to the transverse colon. Barium enema showed an irregular stenotic lesion with serrated changes in the transverse colon. At laparotomy, a solid tumor protruding from the transverse colon wall was resected together with part of the colon. Actinomycosis was determined pathologically from findings of sulphur granules (Druse). Definitive preoperative diagnosis for this disease is extremely difficult, and Actinomycosis should be considered in managing abdominal tumors of unknown origin.

Key words
transverse colon actinomycosis, painless abdominal tumor

Reprint requests
Satoshi Inaba Department of Surgery, Engaru Kousei Hospital N3-1-5 Odori, Engaru-cho, Mombetu, Hokkaido, 099-0494 JAPAN

Accepted
March 28, 2001

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