Je prezentován případ 42leté ženy operované ve 23 letech pro ileus podezřením na Crohnovu chorobu. Pooperační vyšetření resekátu ukázalo však aktinomykózu a nemocná byla léčena antibiotiky s dobrým efektem. Po mnoha letech se objevily příznaky ileu a nemocná byla znovu operována. V tomto případě byla v operačním resekátu potvrzena Crohnova choroba, což předoperační vyšetření nezjistilo. Konečná diagnóza byla stanovena až vyšetřením operačního preparátu, protože ostatní testy selhaly.

We present a case of 42-years old woman, operated in age of 23 because of obstruction, with a suspicion of Crohn's disease. Unexpectedly, postoperative pathological examination revealed actinomycosis and the patient received antibiotics with a good effect. Many years later, according to the recurrence of symptoms of obstruction the patient was operated again. This time, a pathological evaluation of postoperative issues confirmed Crohn's disease, however preoperative tests did now allow to establish the reason of obstruction. Our case shows difficulties in diagnosis of Crohn's disease and actinomycosis. The final diagnosis was established after postoperative pathological examination and all other tests usually helpful in recognition of Crohn's disease were ineffective.

Department of Gastroenterology and Hepatology Silasian Piasts University of Medicine in Wroclaw

Department of Gastroenterology and Hepatology Silasian Piasts University of Medicine in Wroclaw Poland

Department of Pathologic Anatomy Silasian Piasts University of Medicine in Wroclaw Poland

Diagnostické obtíže při diagnostice aktinomykózy a Crohnovy choroby

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