Annals of Tropical Medicine and Public Health
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CASE REPORT
Year : 2013  |  Volume : 6  |  Issue : 6  |  Page : 661-663

Fulminant necrotizing colitis: A rare complication of a common entity


Department of Surgery, Lady Hardinge Medical College, New Delhi, India

Correspondence Address:
Suhani
Department of General Surgery, Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital, New Delhi - 110 001
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.140248

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Acute fulminant necrotizing amebic colitis (FNAC) is a rare complication of intestinal amebiasis that is associated with high mortality and requires prompt diagnosis and surgical intervention. We recently cared for a young male who came with complaints of acute onset abdominal pain, obstipation, and abdominal distension along with a past history of recurring diarrhea over a month. On examination, patient had peritoinits with masking of liver dullness. Patient was resuscitated and taken for exploratory laprotomy which revealed pyoperitoneum, flimsy bowel adhesions, gangrene of cecum, and proximal ascending colon, with multiple colonic perforations along the antimesenteric border in the remaining ascending colon and transverse colon up to the splenic flexure. An extended right hemicolectomy with exteriorization of the proximal and distal loops as an end ileostomy and mucus fistula was done. Postoperatively done amebic serology was highly positive and histopathological examination was suggestive of infective necrosis of cecum and ascending colon. Patient was started on antiamebic medication and discharged on day 16 after a satisfactory recovery. This case report lays emphasis on the prompt diagnosis and treatment of FNAC and supports the empirical use of antiamebic medication in a case of recurring diarrhea/undiagnosed colitis in endemic areas.


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