| Autor: |
Omwansa, Patricia, Nyatsambo, Chido, Ngwisanyi, Weludo, McGrath, Nathan, Moeng, Maeyane Steve |
| Zdroj: |
International Journal of Surgery Case Reports; Sep2023, Vol. 110, pN.PAG-N.PAG, 1p |
| Abstrakt: |
Entamoeba histolytica is an anaerobic protozoan. It infects humans causing Amoebiasis. Most infections are asymptomatic; however, clinical manifestations include intestinal or extraintestinal. In rare instances, patients can present with Ameboma: a mass of granulation tissue consisting of a core of inflammation with peripheral fibrosis related to chronic amoebic infection usually found in the cecum/ascending colon. A 50-year-old patient presented with signs and symptoms of bowel obstruction. He had raised inflammatory markers and was HIV positive on treatment and virally suppressed. At laparotomy a hepatic flexure stricture with desmoid reaction, and wall thickening with induration at the mesenteric border of mid-transverse colon was found, with disseminated nodular disease. Histology confirmed entamoeba histolytica infection. The parasite exists in two forms: a cyst stage and a trophozoite stage: the form causing invasive disease. The presentation of intestinal amoebiasis ranges from an asymptomatic carrier state, colitis, to abscess formation and bowel perforation The management principles: to eliminate the invading trophozoites and eradicate the organism's intestinal carriage and manage complications such as obstruction, fulminant colitis, or toxic megacolon with surgery. This case identifies a rare cause of bowel obstruction in a patient without a travel history. Even with the lack of significant risk factors other than HIV, clinicians should be aware of the infective causes of colonic mass/stricture outside of malignant causes. Entamoeba histolytica is an infection of impoverished communities in developing countries, it should remain high on our differential for tumour-like granulation tissue in the colon. • Tumours/strictures in the large bowel differential should always include infective causes – namely TB and amoebiasis. • Amoebiasis has intestinal and extra-intestinal manifestations, chronic granulomatous changes can mimic non-benign lesions. • Management of amoebiasis although medical, complications can be managed with surgery. • There are variable ways in which parasites can present in endemic areas. [ABSTRACT FROM AUTHOR] |
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