Colonic perforation due to amebiasis, a rare and lethal complication

Abstract

Amebiasis is still a major healthcare concern, especially in developing countries like Ecuador. The lack of sanitary control and hygiene measures make parasites infections still a burden for patients and physicians. Despite infections due to this parasites are usually mild, severe infections and fatal outcomes although rare still occur. Bowel perforation is a rare complication of amebiasis, and unfortunately, it continues to be almost fatal. We present a case of an Ecuadorian patient who presented to the emergency room with an acute abdomen, despite adequate surgery and critical care, the patient regrettably died. Bowel perforation due to Entamoeba histolytica was the final diagnosis.

Figure 1:

(A) Abdominal x-ray, without signs of pneumoperitoneum. (B) Abdominal CT, with diffuse colonic mural thickening and enhancement. (C) Abdominal CT with pericolonic stranding.

Figure 2:

Total colectomy, with multiple areas of necrosis.

Figure 3:

(A) Colonic ulcer, with inflammatory reaction, and hemorrhage. (B) Severe inflammatory reaction on the bowel wall. (C) Trophozoites of Entamoeba histolytica invading the colonic wall.