ABSTRACT
Aortic aneurysms and stenosis occurring in Takayasu arteritis may require aortic prosthesis that can be complicated by aorto-digestive fistula. We report a 41-year-old female who presented with an isolated abdominal pain revealing a para-prosthetic aorto-duodenal fistula complicating a Takayasu arteritis. The diagnosis of aorto-digestive fistula may be difficult if abdominal pain is isolated and imaging inconclusive. Surgical procedure may be necessary to obtain the diagnosis and constitutes the main part of the treatment before fatal outcome.
Subject(s)
Abdominal Pain/etiology , Aorta, Abdominal , Aortic Aneurysm/complications , Duodenal Diseases/etiology , Intestinal Fistula/etiology , Takayasu Arteritis/complications , Vascular Fistula/etiology , Adult , Aortic Aneurysm/diagnosis , Aortic Aneurysm/surgery , Blood Vessel Prosthesis/adverse effects , Diagnosis, Differential , Duodenal Diseases/diagnosis , Duodenal Diseases/surgery , Female , Humans , Intestinal Fistula/diagnosis , Intestinal Fistula/surgery , Takayasu Arteritis/diagnosis , Takayasu Arteritis/surgery , Treatment Outcome , Vascular Fistula/diagnosis , Vascular Fistula/surgeryABSTRACT
PURPOSE: Abdominal actinomycosis is an uncommon chronic infectious disease due to Actinomyces, a Gram-positive bacteria. This saprophytic bacteria of digestive tract and genital mucosa can occasionally become pathogenic mimicking a digestive neoplasia. The aim of this study was to underline diagnostic features of abdominal actinomycosis and to summarize data about clinical, diagnostic and therapeutic approach of this type of infection. PATIENTS: From January 1995 to December 2007, retrospective data concerning patients with abdominal actinomycosis who were followed-up in the University Hospital Sahloul (Sousse, Tunisia) were analysed. RESULTS: Seven patients with abdominal actinomycosis were identified during the study period. All presented with an abdominal mass. The diagnosis of actinomycosis was obtained after surgical resection in all cases. The histological study permitted the diagnosis in six cases, and the surgical samples grew up Actinomyces in two patients. For the five patients who received prolonged and adapted antibiotic therapy, a favourable outcome was observed. CONCLUSION: Actinomycosis must be included in the differential diagnosis of invasive abdominal lesions with "malignant appearance".
Subject(s)
Abdominal Neoplasms/microbiology , Actinomycosis/complications , Abdominal Neoplasms/etiology , Abdominal Neoplasms/surgery , Actinomycosis/drug therapy , Adult , Aged , Anti-Bacterial Agents/therapeutic use , Appendectomy , Colonic Neoplasms/surgery , Female , Granuloma, Plasma Cell/surgery , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
The presence of gas in the spinal canal or pneumorachis is a rare imaging finding, typically incidental. Pneumorachis may be due to several degenerative, traumatic, infectious, tumoral or iatrogenic etiologies. We report three cases of pneumorachis in patients with lumbar back pain. A case occurred in a patient with advanced degenerative disk disease. Another was in a patient with posterior facet synovial cyst. The last was in a patient with locally advanced rectal carcinoma complicated by perforation. Pneumorachis was detected on MRI in two cases and on CT in all three cases.
