Fulminant amoebic colitis during chemotherapy for advanced gastric cancer

Hanaoka, Noboru; Higuchi, Katsuhiko; Tanabe, Satoshi; Sasaki, Takeshi; Ishido, Kenji; Ae, Takako; Koizumi, Wasaburo; Saigenji, Katsunori

doi:10.3748/wjg.15.3445

Cited by 12 publications

(3 citation statements)

References 8 publications

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“…Fulminant colitis describes a clinically acute severe colitis, usually involving the entire large bowel, often associated with systemic illness, sometimes accompanied by colonic dilatation (toxic megacolon), and typically requiring resection . It is a well‐recognised mode of presentation of UC, but there are other causes for a similar picture, including Crohn's disease, infection, ischaemia, drugs, and combinations of these . Ultimately, most fulminant colitis probably represents UC .…”

Section: Pitfallsmentioning

confidence: 99%

“…58,113 It is a well-recognised mode of presentation of UC, but there are other causes for a similar picture, including Crohn's disease, infection, ischaemia, drugs, and combinations of these. 107,114,115 Ultimately, most fulminant colitis probably represents UC. 113 Resections may show severe ulceration and other acute features, but chronic changes are rarely present, even if the cause is IBD.…”

Section: Superficial Fissuring Ulcersmentioning

confidence: 99%

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Ulcerative colitis or Crohn's disease? Pitfalls and problems

Feakins

2013

Histopathology

106

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The interpretation of colorectal biopsies taken for the initial diagnosis of chronic idiopathic inflammatory bowel disease (IBD) is challenging. Subclassification of IBD as ulcerative colitis (UC) or Crohn's disease, which may be particularly difficult, is the subject of this review. Biopsies taken at first presentation are emphasised, partly because their features have not been modified by time or treatment. Aspects of longstanding disease and of resections are also mentioned. The first part of the review comprises background considerations and a summary of histological features that are discriminant, according to published evidence, between UC and Crohn's disease in initial biopsies. Pitfalls and problems associated with making the distinction between UC and Crohn's disease are then discussed. These include: mimics of IBD; inadequate clinical details; unreliable microscopic features; absence of histological changes in early IBD; discontinuity in UC; cryptolytic granulomas; differences between paediatric and adult UC; reliance on ileal and oesophagogastroduodenal histology; and atypical features in IBD resections. Avoidance by pathologists of known pitfalls should increase the likelihood of accurate and confident subclassification of IBD, which is important for optimum medical and surgical management.

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Section: Pitfallsmentioning

confidence: 99%

Section: Superficial Fissuring Ulcersmentioning

confidence: 99%

Ulcerative colitis or Crohn's disease? Pitfalls and problems

Feakins

2013

Histopathology

106

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“…We found very few reports of FAC associated with cancer. Hanaoka, et al have been reported of FAC during chemotherapy for advanced gastric cancer [ 15 ]. There were no reports of FAC associated with lung cancer.…”

Section: Discussionmentioning

confidence: 99%

Lethal multiple colon necrosis and perforation due to fulminant amoebic colitis: a surgical case report and literature review

et al. 2021

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Background Amoebiasis caused by the protozoan species Entamoeba histolytica rarely develops into fulminant amoebic colitis (FAC), but when it does, it shows an aggressive clinical course including colonic perforation, necrotizing colitis, and high mortality. Surgical treatment for FAC patients should be carried out urgently. However, even after surgery, the mortality rate can be 40–50%. Although FAC is one of the most unfavorable surgical diseases with a poor prognosis, there are a few reports on the perioperative diagnosis and management of FAC based on autopsy findings. We herein report the surgical case of a 64-year-old man who developed multiple colon necrosis and perforation due to FAC. A detailed autopsy revealed FAC as the cause of death. Additionally, we reviewed the existing literature on FAC patients who underwent surgery and followed their perioperative diagnosis and management. Case presentation A 64-year-old man presented with anorexia, diarrhea, and altered consciousness on arrival to our hospital. Computed tomography revealed a large mass in the upper right lobe of his lung, and the patient was admitted for close investigation. Bloody diarrhea, lower abdominal pain, and hypotension were observed soon after admission. Urgent abdominal contrast-enhanced computed tomography scan revealed extensive intestinal ischemia, intestinal pneumatosis, and free intra-abdominal gas. The preoperative diagnosis was bowel necrosis and perforation with intussusception of the small intestinal tumor. Emergency subtotal colectomy and enterectomy were performed soon after the contrast-enhanced computed tomography. He was taken to an intensive care unit after surgery. However, he could not recover from sepsis and died with disseminated intravascular coagulation and multiple organ failure on the 10th-day post-surgery. A histopathological examination of the resected colon showed transmural necrosis and massive amoebae invasion. He was diagnosed with FAC. An autopsy revealed that he had developed pulmonary large cell carcinoma with small intestinal metastasis. The death was caused by intestinal ischemia, necrosis and the perforation of the residual bowel caused by amoebae invasion. Conclusions Since FAC is a lethal disease with a high mortality rate and antibiotic therapies except metronidazole are ineffective, preoperative serological testing and perioperative metronidazole therapy in FAC patients can dramatically improve their survival rates.

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Peritonitis

Offner

2013

Pathologie

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Fulminant amoebic colitis during chemotherapy for advanced gastric cancer

Cited by 12 publications

References 8 publications

Ulcerative colitis or Crohn's disease? Pitfalls and problems

Ulcerative colitis or Crohn's disease? Pitfalls and problems

Lethal multiple colon necrosis and perforation due to fulminant amoebic colitis: a surgical case report and literature review

Peritonitis

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