Abstract
A 63-year-old woman who had been hospitalized with cervical sprain and low back pain 9 months earlier following a traffic accident presented to her doctor because of abdominal pain. After mass lesions were identified in the abdomen, she was referred to our hospital with a suspected diagnosis of peritonitis. Abdominal computed tomography (CT) showed a 3.8-cm mass in the adipose tissue cranial to the transverse colon, and antibiotic therapy was initiated based on a diagnosis of an inflammatory tumor. After a 1-week antibiotic therapy, repeat CT scan showed no change in the mass size. Surgery revealed an abscess near the transverse colon involving the transverse colon and greater curvature of the stomach. The tumor, colon, and part of the stomach were then resected. Postoperative progress was good, and the patient was discharged on the postoperative day 15. Histopathological examination revealed granules of Actinomyces in the greater omentum, and actinomycosis was therefore diagnosed. Actinomycosis is a rare disease and few reports have described primary actinomycosis involving the greater omentum. The region of intestinal tract affected by actinomycosis and the area impacted by the seat belt in the previous traffic accident corresponded closely, suggesting a relationship between the seat belt damage, intestinal tract damage, and actinomycosis of the greater omentum.
