1/16. Amebic colitis mistaken for inflammatory bowel disease.In ten patients, amebic colitis was mistakenly diagnosed as ulcerative colitis or crohn disease of the colon because of the similarity of history, physical examination, and routine laboratory studies as well as findings on proctoscopic and barium enema examination. Multiple stool examinations failed to demonstrate ova or trophozoites of entamoeba histolytica. Routine examinations of stools for ova and parasites are inadequate and even a meticulous search for amebas in fresh stool, in scrapings from bowel ulcer, or in biopsy material may give negative results. The indirect hemagglutination test was shown to be a reliable diagnostic test in the evaluation of these cases. Because corticosteroid treatment of patients with amebic colitis may lead to undesirable complications the indirect hemagglutination test results should be obtained in patients in whom such diagnostic confusion is likely.- - - - - - - - - - ranking = 1keywords = inflammatory bowel disease, inflammatory bowel, bowel disease, bowel (Clic here for more details about this article) |
2/16. Colonic perforation in unsuspected amebic colitis.Unsuspected amebic colitis presenting as inflammatory bowel disease, as in our patient, has been previously reported (4, 7, 8). Misdiagnosis, delay in antibiotic treatment, and institution of immunosuppression were the result of failure to identify the parasite in stool specimens and have resulted in suffering, morbidity, mortality, and surgery. In all previously reported cases, routine stool studies failed to identify E. histolytica (4, 7, 8). The correct diagnosis was only established after reviewing the surgical specimen or biopsies obtained endoscopically. Because the erroneous diagnosis of inflammatory bowel disease can lead to disastrous complications, it is imperative to exclude amebic colitis prior to undertaking steroid therapy, especially in patients with a prior history of travel to or residence in areas with endemic E. histolytica (17). We recommend obtaining at least three stool specimens for microscopic examination, as well as testing for serum amebic antibody. patients should submit fresh stool specimens directly to the laboratory to allow for prompt diagnostic evaluation. Such an approach might lead to the improved diagnosis of amebiasis.- - - - - - - - - - ranking = 0.49982643634503keywords = inflammatory bowel disease, inflammatory bowel, bowel disease, bowel (Clic here for more details about this article) |
3/16. 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.- - - - - - - - - - ranking = 0.24991321817252keywords = inflammatory bowel disease, inflammatory bowel, bowel disease, bowel (Clic here for more details about this article) |
4/16. Ultrasonographic findings of amebic colitis.We present here a case of a 64-year-old man with amebic colitis who was examined by ultrasonography. Gray-scale ultrasonography revealed marked thickening of the bowel wall, specifically thickening of the submucosal layer. color Doppler ultrasonography showed hypervascularity of the submucosal and proper muscle layers. With effective treatment, thickening and hypervascularity of the bowel wall disappeared promptly. This is the first report demonstrating ultrasonographic findings of amebic colitis. We conclude that information provided by ultrasonography is useful not only for detecting the bowel abnormality of amebic colitis but also for evaluating the therapeutic effect on amebic colitis.- - - - - - - - - - ranking = 0.0010413819298108keywords = bowel (Clic here for more details about this article) |
5/16. Colonic perforation due to necrotizing amoebic colitis.A seriously ill woman with the history of fever for 14 days and severe pain in abdomen with frequent passage of blood and mucous mixed loose stool for 11 days was admitted in the Surgery Unit-3 of Mymensingh Medical Collage Hospital. On examination the patient was toxic, moderately anaemic and dehydrated and there was diffuse abdominal tenderness with a palpable tender cystic intra abdominal lump in right lower abdomen. Fluidthril was present with absent bowel sound. digital rectal examination revealed bulged anterior rectal wall. X-ray abdomen revealed multiple gas and fluid leveled loops of intestine with increased haziness of the film. On emergency laparotomy it revealed huge amount of faecal matter with fluid in peritoneal cavity. The greater omentum was adherent to caecum with multiple friable necrotic areas in the caecum, transverse and splenic flexure of the colon with multiple small perforations, Subtotal colectomy and end to end anastomosis was done. Histopathological examination of the resected gut revealed features compatible with amoebic ulcer perforations. On 13th post operative day the patient was discharged without any post operative complication and in the 1st follow up after one month the patient was found without any complication.- - - - - - - - - - ranking = 0.00034712730993692keywords = bowel (Clic here for more details about this article) |
6/16. Massive trichuris trichiura infection as a cause of chronic bloody diarrhea in a child.The differential diagnosis of chronic diarrhea is extensive and requires the investigation of several diseases, such as celiac disease, inflammatory bowel disease and irritable bowel syndrome. A few patients infected by trichuris trichiura may present a chronic dysentery-like syndrome in the context of a massive infestation of the colon leading to anemia and growth retardation, but the rarity of that finding demands a high level of suspicion. Herein we report the case of an 8-year-old boy from the rural zone who had suffered diarrhea without blood or mucus for 4 years and was taken to our Service because his mother had noticed the presence of blood on the feces on the 3 previous months. The diagnosis of a massive trichuris trichiura infestation as the cause of the process was only reached by colonoscopy. We stress that trichuris trichiura infection can mimic other forms of inflammatory bowel disease and lead to physical growth retardation and that prolonged regimens of albendazole may be required to the effective treatment of massive infestations.- - - - - - - - - - ranking = 0.50017356365497keywords = inflammatory bowel disease, inflammatory bowel, bowel disease, bowel (Clic here for more details about this article) |
7/16. Differentiating amoebic ulcero-haemorrhagic recto-colitis from idiopathic inflammatory bowel disease: still a diagnostic dilemma.The colon responds monomorphically to a variety of insults thus making it difficult to differentiate invasive amoebic colitis and inflammatory bowel disease (IBD). The authors present a case with chronic dysentery, haematochezia, anaemia and hypoproteinaemia. The endoscopic findings were suggestive of IBD. The stool examination was negative for trophozoites or cysts of parasites. The recto-colonic biopsy specimens showed mucosal inflammation with exudates containing amoebic trophozoites. The patient was successfully treated with metronidazole and iodoquinol. He recovered within two weeks and repeat colonoscopy four weeks after the treatment showed a normal rectum and colon. Clinicians should have a high level of suspicion for amoebic colitis in cases of colitis especially in regions where amoebiasis is still present. Efforts should be made to find the amoebic trophozoites in multiple stool and colonic biopsy specimens.- - - - - - - - - - ranking = 1.2495660908626keywords = inflammatory bowel disease, inflammatory bowel, bowel disease, bowel (Clic here for more details about this article) |
8/16. metronidazole retention enema in the management of severe intestinal amoebiasis.metronidazole is a drug of proven efficacy in amoebiasis; however its use is restricted in patients who cannot take the drug by mouth, because of severe complications of the disease. Preliminary studies in eight control subjects show that rapid absorption and high serum levels are achieved after rectal administration of 2 gm. of metronidazole in 200 ml. of normal saline. Six patients with severe intestinal amoebiasis treated with metronidazole retention enema are presented, and they illustrate the efficacy of the new method of therapy. The efficacy of metronidazole in anaerobic bacteriodes infection and its proven amoebicidal effcet also indicate the possible use of the metronidazole retention enema technique in bowel preparation for colonic surgery in developing countries.- - - - - - - - - - ranking = 0.00034712730993692keywords = bowel (Clic here for more details about this article) |
9/16. Amebic colitis presenting as acute inflammatory bowel disease. Case report.A 41-year-old woman who had lived in the tropics for 23 years developed a clinical picture of inflammatory bowel disease 4 years after resettlement in sweden. Search for ova and trophozoites in stools was negative. As medical treatment was unsuccessful, total colectomy was considered. Repeated colonic endoscopy with multiple biopsies initially failed to show amebiasis, but subsequently the trophozoites were identified in biopsies from the rectosigmoid mucosa. The diagnosis was serologically confirmed. metronidazole treatment was rapidly and lastingly effective.- - - - - - - - - - ranking = 1.2495660908626keywords = inflammatory bowel disease, inflammatory bowel, bowel disease, bowel (Clic here for more details about this article) |
10/16. Atypical clinical manifestations of amebic colitis.Amebic colitis is a disease revealing diverse clinical manifestations and endoscopic gross features and often confused with other types of colitis. In case of misdiagnosis as an idiopathic inflammatory bowel disease or delayed recognition of intestinal amebiasis, an undesirable outcome may occur resulting from erroneous administration of steroids or delayed antiamebic treatment. To demonstrate the pitfalls in the diagnosis and treatment of intestinal amebiasis, 3 cases of amebic colitis with atypical clinical manifestations are presented in this paper. In conclusion, despite the low sensitivities of routine stool examination for parasite and histopathologic confirmation in biopsy specimen, every effort must be made to find amebic trophozoites either in fresh stool or biopsy specimens for prompt and correct diagnosis of amebic colitis when we manage patients with chronic intestinal ulcerations, even though their clinical course and endoscopic findings are not typical of amebiasis. Moreover, following initial successful anti-amebic therapy, more careful clinical, endoscopical, and parasitological follow-up should be done for the early detection of recurrence.- - - - - - - - - - ranking = 0.24991321817252keywords = inflammatory bowel disease, inflammatory bowel, bowel disease, bowel (Clic here for more details about this article) |
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