A Case of Fulminating Amebic Colitis Presenting as an Acute Abdomen

Yoshimi Akamo, Isamu Mizuno, Tatsuo Ichino, Tetsuya Yamamoto, Tamotsu Yasui, Yuji Itabashi, Keizi Mashita, Shu Ishikawa, Nagao shinagawa, Jiro Yura

The First Department of Surgery, Nagoya City University Medical School

We recently saw a case of fulminating amebic colitis presenting as an acute abdomen. A 45-year-old man was admitted to our department with pain in the right lower quadrant of the abdomen and diarrhea. The white cell count was 12,700 and abdominal examination showed signs of peritoneal inflammation. A Gastrografin enema revealed a large ulcer in the cecum. In spite of the use of antibiotics, the patient's condition continued to deteriorate. Because of the increasing risk of perforation of the ulcer, an ileocecal resection was performed. The diagnosis was not determined until trophozoites of Entamoeba histolytica were found in the resected specimen by periodic acid Schiff staining. After the correct diagnosis was made, an antiamebic drug was administered orally. The patient was cured after 12 days of antiamebic drug therapy. Only when the correct diagnosis is made and the proper therapy instituted early enough is it possible to prevent the morbidity and mortality that attend fulminating amebic colitis. Therefore, we should make the diagnosis promptly and institute the appropriate treatment.

Key words
amebiasis, fulminating amebic colitis, acute abdomen

Reprint requests
Yoshimi Akamo The First Department of Surgery, Nagoya City University Medical School
Mizuho-ku, Nagoya, 467 JAPAN

Accepted
July 3, 1991

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