골반 방선균증에 대한 임상적 고찰 = A clinical analysis of pelvic actinomycosis

다국어 초록 (Multilingual Abstract)

Objective: Pelvic actinomycosis is a rare disease, which makes chronic granulomatous suppurative pelvic abscess caused by an anaerobic Gram positive organism. Actinomyces israelii are usually associated with intra-uterine devices, and it is difficult to diagnose exactly before operation. Pelvic actinomycosis is frequently confused with gynecologic malignancy, leading to misdiagnosis and overtreatment. We have experienced 13 cases of pelvic actinomycosis and so provide the advice for treatment of pelvic actinomycosis.
Methods: We reviewed retrospectively 13 cases which had visited to Department of Obstetrics and Gynecology, Pusan National University Hospital from January 1998 to January 2008.
Results: The mean age of patients was 41.2 years old. Main symptoms were abdominal pain, palpable mass and diarrhea. Twelve cases had used the intrauterine devices for 1-20 years. In one case, patient had not used intrauterine device. A case was diagnosed preoperatively by endometrial biopsy and the others suspected to be tuboovarian abscess or malignancy, and then their diagnoses were confirmed by operation. All cases were treated by operation following antibiotics therapy, and 1 case by antibiotics without operation. All cases were completely cured.
Conclusion: In treatment of pelvic actinomycosis, accurate preoperative diagnosis is most important for decreasing complication such as bowel, bladder, and other pelvic organ injury. If the diagnosis was established during operation, postoperative high dose antibiotic therapy will be needed for several months.

참고문헌 (Reference)

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