Pelvi-abdominal as a complication of long-term use of intrauterine device (IUD). The important role of imaging in diagnosis and follow-up

Saad, Ahmed; Ragab, Yasser; Ahmed, Eiman Saeed; Emad, Yasser; Alghamdi, Fahad Ali; Taha, I. M.; Rasker, Johannes J.; Saad, Amr Ahmed

doi:10.1016/j.radcr.2022.08.035

Cited by 1 publication

(2 citation statements)

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“…The colonization rate increases with the duration of its maintenance. 2 , 5 Vasilesco et al 6 reviewed the medical records of 28 patients with abdominopelvic actinomycosis (9 men and 19 women) and the cause of actinomycosis in the studied group was an IUD device in 17 cases from which, 6 patients were admitted because they mimicked a complicated abdominopelvic malignant ovarian advanced ovarian cancer. To reduce the occurrence of this affection, it is recommended that IUDs be changed periodically, every 3–5 years.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, it has been observed that actinomycosis is also sensitive to third-generation cephalosporins, ciprofloxacin, and trimethoprim-sulfamethoxazole. 5 , 8 , 22 Surgical treatment is usually proposed due to the difficulty in diagnosis and also in case of persistent disease and the occurrence of complications such as bowel obstruction and fistula. 13 , 22 This combination of surgery and antibiotics results in healing in the majority of cases ( Table 1 ) which was the case of our patient as the colostomy was indicated to remove the occlusion, and the antibiotic therapy had made it possible to treat inflammatory and infectious phenomena and to free the urinary tract.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pseudo tumor pelvic actinomycosis revealed by colonic obstruction with hydronephrosis: Can extensive surgery be avoided? A case report

Mansouri

Zemni

Souissi³

et al. 2023

Womens Health (Lond Engl)

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Pelvic actinomycosis with an intrauterine device accounts for approximately 3% of all actinomycoses. It is a chronic infectious disease characterized by infiltrative, suppurative, or granulomatous inflammation, sinus fistula formation, and extensive fibrosis, and caused by filamentous, gram-positive, anaerobic bacteria called Actinomyces israelii. The slow and silent progression favors pseudo tumor pelvic extension and exposes the patient to acute life-threatening complications, namely colonic occlusion with hydronephrosis. Preoperative diagnosis is often difficult due to the absence of specific symptomatology and pathognomonic radiological signs simulating pelvic cancer. We discuss the case of a 67-year-old woman who complained of pelvic pain, constipation, and weight loss for 4 months, and who presented to the emergency department with a picture of colonic obstruction and a biological inflammatory syndrome. The computed tomography scan revealed a suspicious heterogeneous pelvic mass infiltrating the uterus with an intrauterine device, the sigmoid with extensive upstream colonic distension, and right hydronephrosis. The patient underwent emergency surgery with segmental colonic resection and temporary colostomy, followed by antibiotic therapy. The favorable clinical and radiological evolution under prolonged antibiotic therapy with the almost total disappearance of the pelvic pseudo tumor infiltration confirms the diagnosis of pelvic actinomycosis and thus makes it possible to avoid an extensive and mutilating surgery with important morbidity.

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Section: Discussionmentioning

confidence: 99%