Amebic Colitis Confirmed Histologically but Initially Diagnosed as Unclassified Colitis, Report of a Case Masaaki Miyaoka 1 , Fuminori Horimukai 1 , Toshihiko saito 1 , Shinroku Ashizawa 1 1The Foueth Department of Internal Medicine, Tokyo Medical College pp.657-660
Published Date 1986/6/25
DOI https://doi.org/10.11477/mf.1403110358
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 A 43-year. old male patient visited our hospital with chief complaint of mucobloody stool on July 1981. He had been abroad in western Europe and southeastern Asia. The barium enema examination demonstrated poorly extended rectum with hemispherical polypoid filling defect in its margin, loss of haustration and tiny niche in the sigmoid colon, and thickened mucosal pattern in both the sigmoid colon and rectum.The appendix was not visualized, but a filling defect above its root was noted. The colonofiberscopic examination showed the rectum with narrow lumen, uneven mucosal pattern and blood coat, and the sigmoid colon and cecum with tiny ulcer, hemorrhage and edematous mucosal pattern. These endoscopic findings were apparently different from chronic inflarnmatory bowel diseases of ulcerative colitis,Crohn's disease, intestinal tuberculosis and so on.

 We initially interpreted them as non-specific inflammation and entertained unclassified colitis at thir point.However, the endoscopic findings were peculiar enough to prompt us to examine again by furthes sectioning six biopsy specimens into 12 slides. One of these slides showed two trophozoid E.. histolytica in the necrotic debris detaching from the mucosa, giving the final diagnosis, amebic colitis. It is suggested that not only mucosa but also necrotic debris should be carefully examined microscopically in cases such as this.

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