Abstract
We experienced an unusual case of amoebic dysentery with lange intestinal perforation that was developed after surgery under first diagnosis of acute appendicitis.
The patient was a 30-year-old Pakistani male, complaining of diarrhea and right side low abdominal pain. Except an increase of leukocyte and accelerated erythrocyte sedimentation, neither blood biochemical examination non ultrasonography revealed any remarkable abnormalities. Because of his increasing revere ileocecal pain appendectomy was made under diagnosis of appendicitis. After an one-week favorable potoperative course, he suddenly suffered from high fever with shoking chill at night time. A suspicion of malearia was risen from his anamnesis, adequate treatment were added, but the symptom of peritonitis appeared. Emergent laparotomy revealed a perforation in the ascending colon and also rupture of heaptic obscess. So he was diognoed as amoebic dysentery. Nourishing amoeba worm was found in the mucus of resected colon and also in the destroyed material of hepatic obscess. After that, he had complications of re-perforation at the residual infectious intestine and failure of utures, leading to reoperation.
Fortunately the patient was gradually getting well and his life could be saved. We think this is a very interesting case to study the fulminant change in amoebic dysentery.
