Ellyson J H, Bezmalinovic Z, Parks S N, Lewis F R
Am J Surg. 1986 Jul;152(1):21-6. doi: 10.1016/0002-9610(86)90131-5.
Acute necrotizing amebic colitis is an uncommon but life threatening development with a high mortality rate, even when properly diagnosed and treated. We report six cases of acute necrotizing amebic colitis, none of which were diagnosed preoperatively. At operation, five of the six patients had friable, necrotic, and gangrenous colon. A right hemicolectomy with ileostomy was performed in two patients and a subtotal colectomy with ileostomy was performed in four patients. Five of the six patients died within 4 weeks of operation. The sole survivor was the patient who had received metronidazole preoperatively. Only after histologic examination of the surgical specimen was the diagnosis made in all cases. If the diagnosis can be made preoperatively and antiamebic therapy instituted, surgical resection may decrease the high mortality rate of this disease.
急性坏死性阿米巴结肠炎虽不常见，但即使正确诊断和治疗，其发展仍可危及生命，死亡率很高。我们报告6例急性坏死性阿米巴结肠炎，术前均未确诊。手术时，6例患者中有5例结肠脆弱、坏死且呈坏疽性。2例行右半结肠切除术加回肠造口术，4例行次全结肠切除术加回肠造口术。6例患者中有5例在术后4周内死亡。唯一的幸存者是术前接受甲硝唑治疗的患者。所有病例均在手术标本经组织学检查后才得以确诊。如果能在术前做出诊断并开始抗阿米巴治疗，手术切除可能会降低该病的高死亡率。
