Hanaoka Noboru, Higuchi Katsuhiko, Tanabe Satoshi, Sasaki Tohru, Ishido Kenji, Ae Takako, Koizumi Wasaburo, Saigenji Katsunori
Department of Gastroenterology, Kitasato University School of Medicine, 2-1-1 Asamizodai, Sagamihara-City, Kanagawa 228-8520, Japan.
World J Gastroenterol. 2009 Jul 21;15(27):3445-7. doi: 10.3748/wjg.15.3445.
A 52-year-old man had bloody stools during chemotherapy for gastric cancer. A colonoscopy revealed necrotizing ulcer-like changes. A biopsy confirmed the presence of amoebic trophozoites. Subsequently, peritonitis with intestinal perforation developed, and emergency peritoneal lavage and colostomy were performed. After surgery, endotoxin adsorption therapy was performed and metronidazole was given. Symptoms of peritonitis and colonitis resolved. However, the patient's general condition worsened with the progression of gastric cancer. The patient died 50 d after surgery. Fulminant amoebic colitis is very rarely associated with chemotherapy. Amoebic colitis should be considered in the differential diagnosis of patients who have bloody stools during chemotherapy.
一名52岁男性在胃癌化疗期间出现便血。结肠镜检查显示有坏死性溃疡样改变。活检证实存在阿米巴滋养体。随后，发生了伴有肠穿孔的腹膜炎，遂进行了急诊腹腔灌洗和结肠造口术。术后进行了内毒素吸附治疗并给予甲硝唑。腹膜炎和结肠炎症状得以缓解。然而，随着胃癌进展，患者的一般状况恶化。患者术后50天死亡。暴发性阿米巴结肠炎与化疗很少相关。对于化疗期间出现便血的患者，鉴别诊断时应考虑阿米巴结肠炎。
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