Gupta Shilpi Singh, Singh Onkar, Shukla Sumit, Raj Mathur K
Department of Surgery, M.G.M Medical College & M.Y. Hospital Indore, 452001 India.
Cases J. 2009 Sep 11;2:6557. doi: 10.4076/1757-1626-2-6557.
Acute Fulminant Necrotizing Amoebic Colitis is a rare complication of amoebiasis that is associated with high mortality. Only one to four such cases are seen per year in large hospitals of India, and only few such cases have been reported in the literature. The condition requires early diagnosis and surgical intervention. We recently cared for a patient who presented with acute abdomen with history of intermittent abdominal pain and diarrhea. Before presenting to our institution he was misdiagnosed as a case of inflammatory bowel disease and had been treated with steroids. On emergency exploration, extensive necrosis and multiple perforations in retroperitoneum involving entire colon were seen. Total colectomy with ileostomy was performed. Postoperative course was marked by septicaemia and multi-organ failure followed by death. This case report emphasizes the importance of early diagnosis and treatment of acute FAC, and associated high mortality.
急性暴发性坏死性阿米巴结肠炎是阿米巴病的一种罕见并发症,死亡率很高。在印度的大型医院中,每年仅能见到1至4例此类病例,文献中报道的此类病例也很少。这种情况需要早期诊断和手术干预。我们最近护理了一名患者,该患者表现为急腹症,有间歇性腹痛和腹泻病史。在就诊于我们机构之前,他被误诊为炎症性肠病并接受了类固醇治疗。在急诊探查时,发现后腹膜广泛坏死并累及整个结肠的多处穿孔。行全结肠切除加回肠造口术。术后病程以败血症和多器官功能衰竭为特征,随后患者死亡。本病例报告强调了急性暴发性坏死性阿米巴结肠炎早期诊断和治疗的重要性以及相关的高死亡率。