CT Findings in Abdominal Actinomycosis

Abdominal actinomycosis is a chronic, progressive, suppurative disease with a fa-vorable response tointravenous treatment with penicillin. In many instances, howev-er, its clinical and radiological findings mayoverlap with those of other inflammatory and neoplastic conditions, and the familiarity with the variousradiological features can thus avoid diagnostic delay s. The purpose of this paper is to describe and discuss theCT findings of abdominal actinomycosis.

Intraperitoneal Ectopic Infestation of Pa rasites Invading through Gastrointestinal Tract: CT Findings

PURPOSE: The purpose of this study was to evaluate the CT findings of parasitic ectopic infestation in theperitoneal cavity, a transitional route for parasites invading the gastrointestinal tract, to migrate to varioustarget organs. MATERIALS AND METHODS: CT scans of nine patients with pathologically(n=8) or serologically(n=1)proven intraperitoneal involvement of parasitic infestation were retrospectively reviewed. The primary causes ofparasitic infestation in nine patients were Paragonimus westermani(n=5), Sparganosis(n=2), and hepaticfascioliasis(n=2). We analyzed the CT findings with regard to the sites and patterns of lesions in the peritonealcavity and gastrointestinal track, as well as in other solid organs. The clinical features of these patients werealso evaluated. RESULTS: The clinical symptoms and signs were chronic abdominal pain and general weakness inseven patients, while peripheral blood eosinophilia was observed in four. The CT features of these nine patientsincluded multiseptated cystic masses of 2 -6cm, diameter (mean 4.1 +/-1.7cm) in the omentum or mesentery insix(67%), omental or mesenteric infiltration in seven(78%), focal peritoneal thickening in seven(78%),lymphadenopathy in five(56%), and ascites in four(44%). In six of the nine patients, the gastrointestinaltract(stomach in four, colon in one, both stomach and colon in one) was concomitantly involved with focal wallthickening. Branching patterns of hypoattenuating lesions were noted in the liver of three patients ; two of thesehad hepatic fascioliasis and one had paragonimiasis. CONCLUSION: Ectopic parasitic infestation in the peritonealcavity manifests as mass formation, adjacent gastrointestinal wall thickening, and focal peritonitis. Anunderstanding of these image features is important for both early diagnosis and adequate treatment.

Abdominal Ultrasonographic Findings of Yersiniosis in Children

PURPOSE: To review abdominal ultrasonography in Yersinia Pseudotuberculosis(YP) infection. MATERIALS AND METHODS: From June 1993 through June 1994, abdominal ultrasonograms were reviewed in 36 patients with YP infection. The age of patients was from 4 to 14 years. A diagnosis of YP infection was made on the basis ofisolation of YP from stool (n=15/36, 41.7%) and by documenting at least a minimum agglutination antibody titer of1:160 or greater (n=34/36, 94.4%). RESULTS: Abdominal US findings were identifed in 33/36 (91.7%) of patients with YP infection. US abnormalities included right lower quadrant abdominal lymphadenopathy in 28/36 (77.8%) of cases ;increased bilateral renal cortical echogenecity with renal enlargement, 11/36 (30/6%) of cases ;hepatosplenomegaly, 6/36 (16.7%) of cases ; bowel wall thickening in termnal ileum and cecum, 4/36 (11/1%) of cases ; and ascites, 2/36 (5.5%) of cases. Three patients revealed no abdominal sonographic finding. CONCLUSION: We conclude that abdominal US can help in the diagnosis of YP infection when US demonstrates multiple right lower quadrant abdominal lymphadenopathy, increased renal cortical echogenecity with renal enlargement, hepatosplenomegaly, intestinal wall thickening or ascites.