Abstract
We report herein on a rare case of abdominal actinomycosis in a 7-year-old girl. She presented with peritoneal irritation in the right lower quadrant, accompanied by leukocytosis and elevation of C-reactive protein levels. Computed tomography showed a granuloma continuing from the tip of the appendix. A preoperative diagnosis of perforated appendicitis forming a granuloma was made. An emergency operation was performed. Laparotomy revealed an elastic hard mass mimicking a malignant retroperitoneal tumor that involved the retroperitoneum, sigmoid colon, urinary bladder, and greater omentum. Sclerosis of the peritoneum continued to the peritoneal reflection in the rectouterine pouch; thus, the mass could not be removed completely. The final diagnosis of actinomycosis was made by a postoperative histopathological examination. The patient has experienced no recurrence, 7 years post-operatively, with long-term postoperative antibiotic administration. The treatment strategy and the role of surgery in a pediatric case of abdominal actinomycosis are discussed.
