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Case Report

Hepatic Actinomycosis with Abdominal Wall and Paracolic Gutter Involvement

Tae Hoon Kim, Myung Shin Kang, Dong Hee Shin, Ji Hye Lee, Jungok Kim
The Ewha Medical Journal 2016;39(1):6-9. Published online: January 29, 2016

Department of Medicine, Sejong General Hospital, Bucheon, Korea.

Jungok Kim. Department of Medicine, Sejong General Hospital, 489 Hohyeon-ro, Sosa-gu, Bucheon 14754, Korea. Tel: 82-32-340-1890, Fax: 82-32-340-3005, jungok37@gmail.com
• Received: July 8, 2015   • Accepted: September 8, 2015

Copyright © 2016, The Ewha Medical Journal

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • A 53-year-old female with intrauterine contraceptive device insertion was admitted for painful abdominal mass on the left upper quadrant abdomen. Abdominal computed tomography scan showed multiple enhancing masses on the right lobe of liver, left abdominal wall and right paracolic gutter. We performed incisional biopsy on the left abdominal wall lesion. Although microorganisms were not identified, the histopathologic result was consistent with actinomycosis which contained sulfur granules within the chronic granulomatous inflammation. She was treated with penicillin agents for 6 months. We report a case of hepatic actinomycosis with abdominal wall and paracolic gutter involvement.
  • Keywords: Actinomycosis; Liver; Abdomen
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Fig. 1

Abdominal computed tomography (CT). It shows 7.5 cm heterogenous enhancing soft tissue mass with necrotizing component at left lower quadrant of abdominal wall (A) (arrow), 5 cm inflammatory lesion with right paracolic gutter invasion (B) (arrow), and 3.5 cm low density lesion with peripheral rim enhancement at the right lobe of liver (C) (arrow). (D, E) Three lesions had no internal connection on coronal view (arrows).

emj-39-6-g001.jpg
Fig. 2

Liver magnetic resonance imaging. It reveals abscess with peripheral rim enhancement in right hepatic dome portion.

emj-39-6-g002.jpg
Fig. 3

Histopathologic findings. (A) Sulfur granules are in the granulation tissues of abdominal wall specimen (H&E, ×100). (B) On staining with the gram stain, several colonies consist of gram-positive, branching filamentous microorganisms within the granule (Gram stain, ×400).

emj-39-6-g003.jpg

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      Hepatic Actinomycosis with Abdominal Wall and Paracolic Gutter Involvement
      Ewha Med J. 2016;39(1):6-9.   Published online January 29, 2016
      DOI: https://doi.org/10.12771/emj.2016.39.1.6
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      Hepatic Actinomycosis with Abdominal Wall and Paracolic Gutter Involvement
      Ewha Med J. 2016;39(1):6-9.   Published online January 29, 2016
      DOI: https://doi.org/10.12771/emj.2016.39.1.6
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      Hepatic Actinomycosis with Abdominal Wall and Paracolic Gutter Involvement
      Image Image Image
      Fig. 1 Abdominal computed tomography (CT). It shows 7.5 cm heterogenous enhancing soft tissue mass with necrotizing component at left lower quadrant of abdominal wall (A) (arrow), 5 cm inflammatory lesion with right paracolic gutter invasion (B) (arrow), and 3.5 cm low density lesion with peripheral rim enhancement at the right lobe of liver (C) (arrow). (D, E) Three lesions had no internal connection on coronal view (arrows).
      Fig. 2 Liver magnetic resonance imaging. It reveals abscess with peripheral rim enhancement in right hepatic dome portion.
      Fig. 3 Histopathologic findings. (A) Sulfur granules are in the granulation tissues of abdominal wall specimen (H&E, ×100). (B) On staining with the gram stain, several colonies consist of gram-positive, branching filamentous microorganisms within the granule (Gram stain, ×400).

      Fig. 1

      Fig. 2

      Fig. 3

      Hepatic Actinomycosis with Abdominal Wall and Paracolic Gutter Involvement
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