Toxic amebic colitis coexisting with intestinal tuberculosis

A patient with a fulminant amebic colitis coexisting with intestinal tuberculosis had a sudden onset of crampy abdominal pain, mucoid diarrhea, anorexia, fever and vomiting with signs of positive peritoneal irritation. Fulminant amebic colitis occurring together with intestinal tuberculosis is an uncommon event and may present an interesting patho-etiological relationship. The diagnosis was proven by histopathologic examination of resected specimen. Subtotal colectomy including segmental resection of ileum, about 80 cm in length, followed by exteriorization of both ends, was performed in an emergency basis. Despite all measures, the patient died on the sixth postoperative day. The exact relationship of fulminant amebic colitis and intestinal tuberculosis is speculative but the possibility of a cause and effect relationship exists. Fulminant amebic colitis may readily be confused with other types of inflammatory bowel disease, such as idiopathic ulcerative colitis, Crohn's disease, perforated diverticulitis and appendicitis with perforation. This report draws attention to the resurgence of tuberculosis and amebiasis in Korea, and the need for the high degree of caution required to detect it.

Fulminant amoebic colitis among children in Basrah

Fulminant amoebic colitis studied in 11 established cases in Basrah, southern Iraq during 1992-1997. Age of patients varied from 6 months to 10 years. There were 7 males and 4 females. All patients presented with abdominal pain [90%], diarrhea [80%] and abdominal distension [65%]. Despite the absence of signs of peritonitis all patients were found to have transmuralr colonic disease with perforation of the colon at one site. In 5 patients resections of the diseased bowel was carried out. The non resectional procedure was done among 3 patients while the remaining 3 patients were unfit for surgical intervention. The overall mortality recorded was [54.5%]. Malnutrition and chemotherapy delay are an important factors contributing to the high mortality

Tratamiento quirúrgico de las formas de amibiasis intestinal / Surgical treatment of severe intestinal amebiasis

Aunque la ambiasis intestinal puede cursar completamente asintomática, existen formas de amibiasis invasora que pueden ocasionar la muerte del pacientes en poco tiempo. Entre las formas graves de amibiasis intestinal han sido descritas la colitis fulminante, el ameboma y la apendicitis amibiana. Se revisaron retrospectivamente los expedientes clínicos de aquellos pacientes sometidos a tratamiento quirúrgico para formas graves de amibiasis intestinal de 1947 a 1985 en el Instituto Nacional de la Nutrición. Se estudiaron 33 pacientes. Viente tuvieron colitis fulminante, 7 ameboma y 6 apendicitis amibiana. La principales manifestaciones fueron dolor abdominal, fiebre y masa abdominal palpable. Once pacientes tuvieron también absceso hepático amibiano. Sesenta y tres por ciento de los pacientes tenían alguna perforación al momento de la cirugía. La mortalidad operatoria fue de 60% y la morbilidad operatoria de 62%. Las formas graves de amibiasis intestinal son complicaciones raras de la amibiasis intestinal con cifras altas de morbilidad y mortalidad. Su sospecha y diagnóstico tempranos permitirian al paciente una mejor evolución

Colitis amibiana fulminante en el adulto: experiencia en el Hospital Universitario San Vicente de Paul / Fulminant amoebic colitis in the adult patient: experience at Hospital Universitario San Vicente de Paul

Se presenta la experiencia en el Departamento de Cirugia del Hospital Universitario de San Vicente de Paul, con 37 casos de colitis amibiana fulminante en el periodo comprendido entre enero de 1971 y diciembre de 1980. Se estudiaron los caracteres clinicos, los metodos diagnosticos y el tratamiento realizado en este grupo de pacientes. Se hace resaltar como la modificacion en la tecnica quirurgica, utilizando procedimientos radicales, ha permitido obtener supervivencia en una entidad que antes se consideraba escencialmente fatal