魚骨腸管穿孔に続発した下腹部放線菌症の1例

ACTINOMYCOSIS CAUSED BY A FISH BONE PENETRATING THROUGH THE SMALL INTESTINE:REPORT OF A CASE

緒言

　放線菌症は口腔内に常在するグラム陽性嫌気性菌（Actinomyces israeli）によつておこる非伝染性の化膿性疾患で，慢性の炎症性肉芽腫形成と瘻孔の形成を特微とする。顔頸部に好発し，ついで腹部，胸部の順にみられるが，瘻孔を形成していない深部放線菌症は悪性腫瘍との鑑別診断が極めて困難である^1）。

　われわれは，最近，魚骨の腸管穿孔に合併し，尿膜管腫瘍との鑑別が困難であつた下腹部放線菌症の1例を経験したので，若干の考察を加えて報告する。

The patient was a 51-year-old male who presented with a history of lower abdominal swelling and pain, pollakiuria, and terminal pain on micturition of one month's duration. A round mass, 6 cm in diameter which was smooth, hard, and mildly tender to palpation was noted in the lower abdominal midline. Cystoscopy showed an indurated protuberance in the posterior wall of the bladder. The patient was admitted under the diagnosis of suspected urachal tumor. At the time of admission, the patient's temperature was 37.3℃.