J Korean Soc Coloproctol.  2007 Dec;23(6):437-440. 10.3393/jksc.2007.23.6.437.

Pelvic Actinomycosis: Is It Possible to Diagnose Preoperatively?

• Hwang HP
• Lee MR
• Kim JH

• KMID: 2199197
• DOI: http://doi.org/10.3393/jksc.2007.23.6.437

Abstract

PURPOSE: Pelvic actinomycosis is a rare infection which presents difficulty in establishing a correct preoperative diagnosis. The aim of this study is to find diagnostic clues for pelvic actinomycosis preoperatively.
METHODS
A retrospective analysis performed at Chonbuk National University Hospital identified 9 patients with a diagnosis of pelvic actinomycosis from 1998 to 2006.
RESULTS
All patients were women with a history of intrauterine device (IUD) use. Abdominal pain (7 cases), palpable mass (3 cases), defecation difficulty (3 cases) and leucorrhea (2 cases) were the main presenting complaints. The median duration of presenting symptoms was 78 days (range: 10~365 days). The median duration of using an IUD unchanged was 11 years (range: 4~30 years). A correct diagnosis was made in 3 patients (33%) without exploration. All patients were treated with antibiotics after pathologic diagnosis. There was no recurrence.
CONCLUSIONS
It is very difficult to diagnose pelvic actinomycosis preoperatively. Howere, if a mass or a pelvic abscess is found in women with an IUD that has been unchanged for a long time, pelvic actinomycosis should be suspected to avoid unnecessary exploration.

Keyword

Pelvic actinomycosis; Intrauterine device

MeSH Terms

Abdominal Pain
Abscess
Actinomycosis*
Anti-Bacterial Agents
Defecation
Diagnosis
Female
Humans
Intrauterine Devices
Jeollabuk-do
Recurrence
Retrospective Studies
Anti-Bacterial Agents