Abdominal actinomycosis as a rare cause of abdominal tumor mimicking incarcerated umbilical hernia

A 35-year-old female patient was urgently admitted due to severe abdominal pain lasting for two days.Physical examination revealed an afflictive tumor localized within the umbilical region, mimicking incarcerated umbilical hernia.The patient underwent an abdominal ultrasound that demonstrated a 7.6cm x 4.3cm x 55cm heterogeneous hypoechogenic lesion, which may correspond with incarcerated abdominal hernia.Plain abdominal X-ray revealed no gas-fluid levels or free air beneath diaphragm (Figure 1A).Comprehensive blood test analysis showed an elevated CRP level (26.7 mg/l, reference range 0-5 mg/l) and WBC count