Colonoscopic diagnosis of amebiasis: a case series and systematic review

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• 作者：Ko-Chao Lee ; Chien-Chang Lu ; Wan-Hsiang Hu…
• 关键词：Amebiasis ; Colonoscopy ; Diagnosis ; Endoscopic examination ; Entamoeba histolytica
• 刊名：International Journal of Colorectal Disease
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：30
• 期：1
• 页码：31-41
• 全文大小：413 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Internal Medicine
  Gastroenterology
  Hepatology
  Proctology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-1262

文摘

Purpose Nonspecific gastrointestinal symptoms make diagnosis of amebiasis difficult. Certain colonoscopic findings predict amebic colitis while others suggest different diagnoses. We aimed to evaluate the diagnostic capability of colonic evaluation of amebiasis. Methods We retrospectively reviewed data of all amebiasis cases admitted to our institution between 2003 and 2012. Cases were diagnosed by clinical presentation, laboratory examinations, and colonoscopy with biopsy and microscopic examination. Patients were stratified as right-sided colitis and proctosigmoiditis. A systematic review was conducted by searching Medline, Cochrane, EMBASE, and Google Scholar using key words amebiasis, amebic colitis, amebic proctosigmoiditis, colonoscopy, and Entamoeba histolytica. Data were extracted from articles meeting the inclusion criteria. Colonoscopic findings were described and studies were assessed for quality. Results The current series included 20 patients (5 male, 15 female, median age 51), 7 with amebic liver abscess and 13 with amebic colitis. Colonoscopic findings of right-sided colitis included aphthae or erosions, ulcers, exudates, or edematous swollen mucosa in cecum, and findings for proctosigmoiditis were edematous swollen mucosa with bloody exudate. In 25 studies, colonoscopic findings of 41 patients (36 male, 5 female, median age 43.39?years) included mainly ulcers in the cecum and rectum, ulcerated mass, and edematous mucosa; and in fewer patients, submucosal invasion suggestive of colon cancer, bleeding ulcers, proctitis, and ulcers with aphthae in rectum. Conclusions Colonic evaluation of suspected amebiasis is of diagnostic value when accompanied by biopsy and microscopic identification of Entamoeba species. Colonoscopic manifestations vary between right-sided colitis and proctosigmoiditis.