Amoebic colitis presenting as ileocaecal intussusception - a rare case

Abstract

Ileocaecal intussusception is a common cause of acute intestinal obstruction presenting as a surgical emergency. We report a case of amoebic colitis in a 62 years old man complaining of acute colicky pain in the right iliac fossa, associated with a three-day history of constipation but no other gastrointestinal tract symptoms. There was rebound tenderness on palpation of the right iliac fossa. Ultrasound scans revealed free fluid and a loop within a loop image in this area. At laparotomy, we discovered an Ileocaecal intussusception associated with a gangrenous caecum. A right hemicolectomy was performed with satisfactory outcome. The final diagnosis of amoebic colitis was obtained post-operatively using serology and pathology. This rare aetiology must be considered in patients with acute pain in the right iliac fossa in the tropical regions. Tropical surgeons must be aware of this scenario before they label a case of intussusception as idiopathic. The identification and treatment of invasive amoebic infection may reduce the recurrence of idiopathic intussusception.

Keywords: amoebic; colitis; idiopathic; ileocaecal; intussusception.

Figure 1:

Intraoperative photograph showing ileocaecal intussusception.