Sayeed Mohmad Sejarali, Saikhedkar Swapnil, Rajput Jay Prakash S, Parmar Pooja, Saiyad Sajidali S, Saiyad Tehsin, Kumar R Chetan, Shah Nehal
Department of Gastrointestinal Surgery, Aryavart Hospital, Meerut, IND.
Department of Physiology, Pacific Medical College and Hospital, Udaipur, IND.
Cureus. 2025 Feb 6;17(2):e78632. doi: 10.7759/cureus.78632. eCollection 2025 Feb.
Introduction Amoebiasis, caused by , remains a significant global health concern, particularly in endemic regions such as India. An amoebic liver abscess (ALA) is the most common extraintestinal manifestation of amoebiasis, often linked to colonic pathology. However, the correlation between hepatic and colonic involvement is underexplored, leading to missed diagnostic opportunities and suboptimal management. This study investigates the clinical significance of colonic pathology in ALA patients through colonoscopic evaluations. Materials and methods This observational study included 110 ALA patients evaluated over 3.5 years in a tertiary care hospital in Gujarat, India. Patients underwent colonoscopy within 48 hours of initiating anti-amoebic treatment. Data on demographic characteristics, clinical presentations, and colonoscopic findings were analyzed using descriptive and inferential statistical methods. Inclusion criteria encompassed adult patients diagnosed with ALA, while those with pyogenic liver abscesses or contraindications to colonoscopy were excluded. The ethical approval and informed consent ensured compliance with research standards. Results and discussion Colonic abnormalities were identified in 55.45% of patients with ALA, with ulceration being the most common (33.64%). Larger abscesses (>10 cm) and multiple liver abscesses were significantly associated with colonic pathology (p = 0.002 and p = 0.019, respectively), particularly in the right lobe (p = 0.037). Middle-aged patients (31-50 years) had the highest prevalence (100%), while males were more affected than females (4.64:1), likely due to risk factors like alcoholism and obesity. Patients with multiple abscesses had greater odds of colonic findings (OR = 3.09), as did those with larger abscesses (OR = 4.67). These findings emphasize the importance of colonoscopy in high-risk patients to improve diagnosis and treatment strategies. Conclusion This study links colonic pathology in ALA to age, sex, and abscess characteristics, highlighting higher prevalence in middle-aged males and those with larger or multiple abscesses. Despite limitations, it underscores colonoscopy's role in improving diagnosis and management.
引言 由[具体病原体]引起的阿米巴病仍然是一个重大的全球健康问题，尤其是在印度等流行地区。阿米巴肝脓肿（ALA）是阿米巴病最常见的肠外表现，通常与结肠病变有关。然而，肝脏和结肠受累之间的相关性尚未得到充分研究，导致诊断机会的错失和管理的不理想。本研究通过结肠镜检查评估ALA患者结肠病变的临床意义。
材料和方法 这项观察性研究纳入了印度古吉拉特邦一家三级护理医院在3.5年内评估的110例ALA患者。患者在开始抗阿米巴治疗后48小时内接受结肠镜检查。使用描述性和推断性统计方法分析人口统计学特征、临床表现和结肠镜检查结果的数据。纳入标准包括诊断为ALA的成年患者，而化脓性肝脓肿患者或结肠镜检查有禁忌证的患者被排除。伦理批准和知情同意确保了研究符合标准。
结果与讨论 在55.45%的ALA患者中发现了结肠异常，其中溃疡最为常见（33.64%）。较大的脓肿（>10 cm）和多发性肝脓肿与结肠病变显著相关（分别为p = 0.002和p = 0.019），尤其是在右叶（p = 0.037）。中年患者（31 - 50岁）患病率最高（100%），男性比女性受影响更大（4.64:1），这可能是由于酗酒和肥胖等危险因素。多发性脓肿患者出现结肠病变的几率更高（OR = 3.09），脓肿较大的患者也是如此（OR = 4.67）。这些发现强调了结肠镜检查在高危患者中对改善诊断和治疗策略的重要性。
结论 本研究将ALA患者的结肠病变与年龄、性别和脓肿特征联系起来，突出了中年男性以及脓肿较大或多发患者中较高的患病率。尽管存在局限性，但它强调了结肠镜检查在改善诊断和管理方面的作用。
