1 F 2 F 3 F 4 F 5 F 6 F 7 F 8 F 9 F 10 F 11 F 12 F 13 F 14 F 15 F 16 F 17 F 18 M 19 M 20 F 21 F 22 F IUD, intrauterine device. Table 1. Summary of 22 Patients with Intrabominal Actinomycosis Time Initial Patient Signs and Presence Sex to leukocyte no. symtom diagnosis of IUD count (mm3) Painful mass 15 No 8,690 Abdominal pain 7 No 9,340 Abdominal pain 6 No 11,890 Abdominal pain 18 Yes 16,500 Fever 4 No 18,330 Abdominal pain 15 No 11,750 Abdominal pain 8 Yes 22,900 No symptom 3 Yes 13,570 Abdominal pain 7 No 5,950 Painful mass 14 No 9,440 Abdominal pain 15 No 8,990 Abdominal pain 17 No 15,300 Abdominal pain 7 Yes 20,940 Fever 12 Yes 7,400 Abdominal pain 9 No 14,560 Abdominal pain 19 No 16,210 Abdominal pain 17 Yes 7,650 Abdominal pain 13 N / A 4,180 Abdominal pain 10 N / A 20,490 Abdominal pain 8 No 5,310 Painless mass 4 Yes 16,970 Abdominal pain 6 Yes 14,480 summarized in Table 1. The clinical data including age, gender, mass size, preoperative diagnosis, presence and duration of intrauterine device (IUD) were retrospectively analyzed. Intrabdominal mass assessments consisted of physical examination, colonoscopy, ultrasonography, and abdominopelvic CT scan. RESULTS The clinical details of these patients are presented in Table 2. There were two men and twenty women with a mean age of 42.8 (range, 24 - 69) years. Twelve patients presented with masses or abdominal pain, whereas three patients presented with acute appendicitis (Table 3). Among the twenty two patients, only two patients presented with a colonic mass mimicking colon cancer. Fifteen patients (68.2%) had leukocytosis with a mean WBC count of 12,765 mm3 (range; 4,180 - 22,900 mm3). None of the patients presented with small bowel or colon obstruc- tion. However, emergency surgery rate was 50% due to peritonitis symptoms. A preoperative abdominal CT scan Myung-Min Choi, et al. 556 Yonsei Med J http://www.eymj.org Volume 50 Number 4 August 2009 Antibiotics Risk factors Recurrences IV penicillin None None IV penicillin None None IV penicillin None None IV penicillin None None IV penicillin None None IV penicillin None None IV penicillin None None IV penicillin None None IV penicillin None None IV penicillin None None IV penicillin Liver cirrhosis None IV doxycline None None IV ciprofloxacin None None IV penicillin None None IV penicillin None None IV penicillin None None IV penicillin None None IV penicillin DM None IV penicillin None None IV penicillin None None IV penicillin DM / Hypertension None IV penicillin None None 12,765 (4,180 - 22,900) Table 2. Patients’ Characteristics Intrabdominal actinomycosis (n = 22) Age (yrs) Mean (range) 42.8 (24 - 69) Gender: M / F 2 : 20 IUD (n = 20) Yes 12 (60%) No 8 (40%) Emergency vs. elective operation Yes 11 (50%) No 11 (50%) WBC, mm3 Mean (range) GI obstruction Yes 0 (0.0%) No 100 (0.0%) Mass size, cm Mean (range) 5.5 (2.5 - 11.0) IUD, intrauterine device; WBC, white blood cell; GI, gastrointestinal.