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Efficiency of combined colonoscopy and computed tomography for diagnosis of colonic actinomycosis: a retrospective evaluation of eight consecutive patients.
Int J Colorectal Dis 2000; 15(4):236-42IJ

Abstract

The preoperative diagnosis of colonic actinomycosis is accurate in fewer than 20% of patients. Colonoscopy and computed tomography (CT) findings were analyzed to ascertain their diagnostic value and their role in determining therapeutic modality and outcome. Before and after treatment we retrospectively evaluated eight consecutive patients with colonic actinomycosis, all of whom were women with a previous history of intrauterine contraceptive device use. Median follow-up period was 20 months (7-57). Localized nodules were found in all cases by colonoscopy; half of these nodules included umbilication at the apex. The colonic mucosa demonstrated normal to moderate inflammation as well as hyperemia and edema. Mucosal ulceration was found in only one case. All cases showed some degree of stenosis. These findings differ from those in other inflammatory or neoplastic diseases of the colon. Abdominopelvic CT revealed extramural involvement of heterogeneous lesions all cases. Contrast enhancement also indicated severe thickening of the colonic wall (7-20 mm) with focal and dense enhancement in six cases. Seven of eight patients required surgery for diagnostic or therapeutic purposes. Complete resolution was determined using both colonoscopy and CT. As more than half of these cases could have been safely managed using an adequate antibiotic treatment, diagnostic studies indicating a high likelihood of colonic actinomycosis should be evaluated to avoid unnecessary surgeries carried out for diagnostic purposes. A combination of colonoscopy and CT appears to be important for both diagnosis and management because of their compensatory findings of mucosal and extramucosal lesions, respectively.

Authors+Show Affiliations

Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea. jckim@www.amc.seoul.krNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Studies
Journal Article

Language

eng

PubMed ID

11008724

Citation

Kim, J C., et al. "Efficiency of Combined Colonoscopy and Computed Tomography for Diagnosis of Colonic Actinomycosis: a Retrospective Evaluation of Eight Consecutive Patients." International Journal of Colorectal Disease, vol. 15, no. 4, 2000, pp. 236-42.
Kim JC, Ahn BY, Kim HC, et al. Efficiency of combined colonoscopy and computed tomography for diagnosis of colonic actinomycosis: a retrospective evaluation of eight consecutive patients. Int J Colorectal Dis. 2000;15(4):236-42.
Kim, J. C., Ahn, B. Y., Kim, H. C., Yu, C. S., Kang, G. H., Ha, H. K., & Lee, M. G. (2000). Efficiency of combined colonoscopy and computed tomography for diagnosis of colonic actinomycosis: a retrospective evaluation of eight consecutive patients. International Journal of Colorectal Disease, 15(4), pp. 236-42.
Kim JC, et al. Efficiency of Combined Colonoscopy and Computed Tomography for Diagnosis of Colonic Actinomycosis: a Retrospective Evaluation of Eight Consecutive Patients. Int J Colorectal Dis. 2000;15(4):236-42. PubMed PMID: 11008724.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficiency of combined colonoscopy and computed tomography for diagnosis of colonic actinomycosis: a retrospective evaluation of eight consecutive patients. AU - Kim,J C, AU - Ahn,B Y, AU - Kim,H C, AU - Yu,C S, AU - Kang,G H, AU - Ha,H K, AU - Lee,M G, PY - 2000/9/29/pubmed PY - 2001/2/28/medline PY - 2000/9/29/entrez SP - 236 EP - 42 JF - International journal of colorectal disease JO - Int J Colorectal Dis VL - 15 IS - 4 N2 - The preoperative diagnosis of colonic actinomycosis is accurate in fewer than 20% of patients. Colonoscopy and computed tomography (CT) findings were analyzed to ascertain their diagnostic value and their role in determining therapeutic modality and outcome. Before and after treatment we retrospectively evaluated eight consecutive patients with colonic actinomycosis, all of whom were women with a previous history of intrauterine contraceptive device use. Median follow-up period was 20 months (7-57). Localized nodules were found in all cases by colonoscopy; half of these nodules included umbilication at the apex. The colonic mucosa demonstrated normal to moderate inflammation as well as hyperemia and edema. Mucosal ulceration was found in only one case. All cases showed some degree of stenosis. These findings differ from those in other inflammatory or neoplastic diseases of the colon. Abdominopelvic CT revealed extramural involvement of heterogeneous lesions all cases. Contrast enhancement also indicated severe thickening of the colonic wall (7-20 mm) with focal and dense enhancement in six cases. Seven of eight patients required surgery for diagnostic or therapeutic purposes. Complete resolution was determined using both colonoscopy and CT. As more than half of these cases could have been safely managed using an adequate antibiotic treatment, diagnostic studies indicating a high likelihood of colonic actinomycosis should be evaluated to avoid unnecessary surgeries carried out for diagnostic purposes. A combination of colonoscopy and CT appears to be important for both diagnosis and management because of their compensatory findings of mucosal and extramucosal lesions, respectively. SN - 0179-1958 UR - https://www.unboundmedicine.com/medline/citation/11008724/Efficiency_of_combined_colonoscopy_and_computed_tomography_for_diagnosis_of_colonic_actinomycosis:_a_retrospective_evaluation_of_eight_consecutive_patients_ L2 - http://www.diseaseinfosearch.org/result/414 DB - PRIME DP - Unbound Medicine ER -