Gastric Outlet Obstruction Due to Actinomycosis, An Uncommon Presentation of a Rare Disease: A Case Report

Abstract

Background: Actinomyces is gram positive Bacterium part of normal human flora. Even though actinomyces infect various organ systems, including the gastrointestinal tract (GIT), gastric outlet obstruction is extremely uncommon.

Case Presentation: We present a case of a 66-year-old female patient who presented with nausea, vomiting and unintentional weight loss. Clinical imaging and upper GI endoscopy revealed narrowed gastric pylorus diagnosed as gastric outlet obstruction (GOO). The Patient required multiple gastroscopies with balloon dilatation and biopsy specimens. Histopathology was consistent with Actinomyces. Subsequent
appropriate antibiotics therapy led to GOO resolution and clinical improvement.

Discussion: Actinomyces presenting as GOO is a rarely seen clinical diagnosis that may mimic malignancy. It must be considered in the differential diagnosis of abdominal masses broadly and tumor-like infiltrative lesions of the stomach particularly. Proper antibiotic therapy renders favorable outcomes and eliminates unwarranted invasive intervention.

Conclusion: Actinomyces presenting as GOO is a rare differential diagnosis of abdominal masses broadly, and tumor-like infiltrative lesions of the stomach particularly. Proper antibiotic therapy facilitates favorable outcomes and eliminates unwarranted invasive interventions. Our patient is such an example where gastric actinomycosis was managed medically and the patient improved, avoiding unnecessary surgical interventions.