Fulminant amebic colitis a life threatening rare entity

ABSTRACT

To present two uncommon cases of Fulminant Amebic Colitis. Retrospective study. Surgical and Medical Department at Salmaniya Medical Complex. From March to September 2008, two cases of fulminant Amebic Colitis were seen and reviewed as far as their presenting features, investigation, characteristic histopathologic picture, and management. Two cases of Amebic Colitis were found in the hospital records during the last ten years. Both presented to the clinic within the last six months. Both patients were males, young, from poor socio-economic class and are originally from Indian subcontinent. Both had vague and mild presentation. One progressed to massive lower GI bleeding and the other one progressed to colonic perforation and peritonitis. The second case had CT scan, which showed signs of colitis and suspected perforation but was not diagnostic of Amebic Colitis. The first case had subtotal colectomy and primary anastomosis; while, the second case had limited colectomy with proximal colostomy and distal mucus fistula. The diagnosis was based on histopathology of the resected specimens. Serology was confirmatory in only one patient. Fulminant Amebic Colitis is a rare entity. Clinical awareness and early surgical intervention are very important in the outcome. Two cases of fulminant Amebic Colitis have been managed by colonic resection of the affected part, in addition to Metronidazole and broad-pectrum antibiotic