Case Report

Fulminant amoebic colitis in the era of computed tomography scan: A case report and review of the literature

Suman Mewa Kinoo, Vikesh V. Ramkelawon, Jaynund Maharajh, Bugwan Singh
South African Journal of Radiology | Vol 22, No 1 | a1354 | DOI: https://doi.org/10.4102/sajr.v22i1.1354 | © 2018 Suman Mewa Kinoo | This work is licensed under CC Attribution 4.0
Submitted: 04 April 2018 | Published: 15 August 2018

About the author(s)

Suman Mewa Kinoo, Department of Surgery, University of KwaZulu-Natal, King Edward VIII Hospital, Durban, South Africa
Vikesh V. Ramkelawon, Ethekwini Hospital and Heart Centre, Durban, South Africa
Jaynund Maharajh, Department of Radiology, University of KwaZulu-Natal, King Edward VIII Hospital, Durban, South Africa
Bugwan Singh, Department of Surgery, University of KwaZulu-Natal, King Edward VIII Hospital, Durban, South Africa

Abstract

Amoebic colitis, caused by ingestion of water or food contaminated with the protozoan Entamoeba histolytica, can progress to a fulminant colitis. Computed tomography (CT) findings reported in the literature on this type of colitis are sparse. We present a 59-year-old male patient with a one-week history of progressive abdominal pain, abdominal distension and associated watery and bloody diarrhoea. A CT scan revealed deep ulcerations with submucosal and intramural tracking of contrast. Colonoscopy and biopsy confirmed a diagnosis of Amoebic colitis. The patient required a laparotomy and demised. Deep ulcerations with submucosal and intramural tracking of contrast on CT are diagnostic of fulminant amoebic colitis. Although not demonstrated at CT in this case, discontinuous bowel necrosis, omental wrapping (seen at laparotomy in our case) and neovascularisation of the bowel wall may be other features to look out for.


Keywords

amoebic colitis; computed tomographyp; fulminant amoebic colitis

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