Time-Course of Changes in the Colonoscopic Findings of Fulminant Amebic Colitis

Abstract

A 65-year-old man was referred to our hospital with a history of right lower quadrant pain. The patient had not been abroad or engaged in homosexual behavior. Abdominal computed tomographic examination revealed a tumor of the cecum, and colonoscopic examination showed a type 2 tumor of the cecum and multiple small ulcers in the whole colon. With the suspected diagnosis of multiple malignant lymphoma, the patient was admitted to the hospital. The following day, the patient complained of severe abdominal pain, and was diagnosed as having peritonitis associated with colonic penetration. Emergency surgery was performed, which revealed penetration at the cecum. Ileocecal resection and intraperitoneal drainage were performed. The resected specimen showed multiple ulcers with necrotic tissue. On day 7 after the operation, Entamoeba histolytica was identified in the resected specimen. The patient was then treated with metronidazole, and discharged home without any complications. Follow-up examinations at 2, 6 and 10 months after the operation revealed rapid healing of the ulcers following the treatment, although the erythema persisted for a relatively long time.