A CASE OF FULMINANT AMEBIC COLITIS ASSOCIATED WITH MULTIPLE COLON PERFORATIONS

Abstract

We experienced a case of fulminant amebic colitis associated with multiple colon perforations. A 31-year-old man was admitted to the hospital because of abdominal pain, fever and diarrhea. He was diagnosed as having an intraabdominal abscess due to perforation of the bowel based on abdominal computed tomography (CT), and an emergency operation was performed. During the surgery, necrotic changes and multiple perforations were noted at the cecum, ascending, transverse and discending colons. These colons were resected. Intraoperatively, we suspected of amebic colitis. Cytological examination by periodic acid Schiff staining of ascites showed Entamoeba histolytica. He attained remission without mortal complications. In Japan, amoebiasis has been increasing recently, especialy, in patients who have returned from abroad and have practiced homosexual behavior. The mortality rate of fulminant amebic colitis is very high. Prompt diagnosis and treatment are important to save the patient's life. Cytological examination by PAS staining of ascites is useful for making prompt diagnosis.