[Abdominal actinomycosis--ileo-vaginal fistula as clinical manifestation. Case report and literature review]

In 1985 sigmoid resection was performed in an 81-year-old patient with recurrent sigmoid diverticulitis. Due to adenomyosis uteri, hysterectomy was performed at the same time. Approximately one year after an uneventful recovery fetid leukorrhea occurred. Radiograms revealed a fistula between the terminal ileum and vagina. Adhesions between the terminal ileum and vaginal stump were surgically resolved and an ileum segment resection was performed. Postoperative recovery was uncomplicated and the patient has been symptom-free since. The histological findings of Actinomyces microorganisms, thread-like foreign material and detritus drew our attention to a rare instance of abdominal actinomycosis. Publications of purely historical interest dealing with therapeutic measures before the antibiotic era are not taken into consideration. The clinical picture, incidence and therapy of abdominal actinomycosis are described in the light of the literature.