Volume 64 - 2001 - Fasc.4 - Case reports
Ileo-caecal actinomycosis : Report of a case simulating complicated inflammatory bowel disease
Abdominal actinomycosis is a rare infectious disease caused by Actinomyces israelii, a gram-positive anaerobic saprophyte germ that is a normal inhabitant of the upper intestinal tract in humans. Actinomyces Israeli rarely cause abdominal infections or actinomycosis. Abdominal actinomysosis is characterised by fistulae and abscesses and may mimic cancer or inflammatory bowel disease. Abdominal actinomycosis is difficult to diagnose preoperatively, and often require surgical removal of the diseased tissue, allowing pathologists for giving the definitive diagnosis, revealed by characteristic "sulfur granules". The authors report herein the case of a 47-year-old man who presented with diarrhoea and abdominal pain. Abdominal computed tomography evoked complicated inflammatory bowel disease and surgical procedure was decided. Laparoscopic exploration did not provide further significant information, and laparotomy with diseased bowel resection was performed. Pathology demonstrated "sulfur granules" and allowed the diagnosis of abdominal actinomycosis. This case demonstrated that abdominal actinomycosis should be included in the differential diagnosis when computed tomography shows an infiltrative and inflammatory mass.
Multicentric tumor of the oesophagus and its clinical significance; case report and review of the literature
Simultaneous occurrence of the esophageal tumor at multiple sites in a single patient is unusual. Here in, we described a patient had three separate turnoral nodules with ulceration of the esophagus. Thorax CT scan, X-ray and endoscopy revealed the only two tumoral lesion at the lower esophagus. But, the other tumoral lesion at the upper part of the esophagus was detected at operation and histopathologic examination. The aspect of treatment was changed according to this new condition during the operation. We discussed the multicentric tumoral lesions of the esophagus in view of the literature.
