COLONOSCOPIC APPROACH TO AMEBIC COLITIS

Abstract

In 10 patients with amebic colitis 23 colonoscopic examinations were performed during a period of 15 years (1968-1983), All patients were male. The age distribution ranged from 23 to 64 years old and the mean age was 44.4. The duration of subjective symptoms before admission ranged from 7 day to 7 years. Most of them complained of watery diarrhea or mucousbloody stool. Only 4 patients (40%) had a history of travel to foreign countries. In case of amebic colitis, the findings of colonoscopic examination were studied. There were localized, skip and diffuse type in the distribution of endoscopic changes. The commonest site of the lesion was the rectum and cecum. The characteristic endoscopic findings were varioliform elevated lesion, punctate hemorrhage, small round ulcer and edematous thickening of mucosal folds. The intervening mucosa among them showed intact or slightly edematous change. The other findings were erosion, varif orm ulceration, edema, reddness and stricture which were common to the other inflammatory bowel diseases. Detectability of E. histolytica was 3/7 (49.2%) in feces, 7/9 (77.8%) in biopsy specimens and 5/5 (100%) in colonic mucus. Serological test for amebiasis was performed in 4 patients and showed positive titers in all. Pathologically 24 of 104 biopsy specimens revealed a cluster of E. histolytica in the necrotic tissue. We concluded that biopsy specimens should be taken from the center of the ulcerative lesion. When the mentioned characteristic pictures are found, rectal mucus should be examined. Application of serological examination also plays an important role in the diagnostic procedures.