Complex diagnosis of ulcerative necrotizing colitis of parasitic etiology (clinical case)

DOI: https://doi.org/10.25512/DIR.2019.13.1.08

For quoting:
Vladimirova E.S., Popova I.E., Tikhonova D.V., Mironov A.V., Shavrina N.V., Titova G.P. "Complex diagnosis of ulcerative necrotizing colitis of parasitic etiology (clinical case)". Journal Diagnostic & interventional radiology. 2019; 13(1); 65-72.

authors:

Vladimirova E.S.

Popova I.E.

Tikhonova D.V.

Mironov A.V.

Shavrina N.V.

Titova G.P.

keywords:

amebic colitis

diagnostics

ultrasound

computed tomography

colonoscopy

Abstract:

Background: expansion of tourism business in countries of South and Southeast Asia, Africa, and South America led to the appearance of rare parasitic diseases in Russia, Europe, and the United Kingdom. In our country, more than 1.3 million patients with various parasitosis are officially registered annually, among which there is an increase in the incidence of intestinal protozoa.

Aim: was to show features of the diagnosis of acute manifestations of necrotic amebic colitis, which simulated severe intoxication with manifestation of clinics of acute surgical disease and intestinal bleeding

Material and methods: using the example of case report of a 70-year-old woman, the possibility of complex diagnostics using abdominal ultrasound, abdominal computed tomography, colonoscopy with biopsy of intestinal ulcers and parasitological research methods is shown. Results: detoxification, anti-inflammatory therapy in a surgical hospital and instrumental examination allowed us to objectively evaluate and conduct targeted therapy avoiding serious complications.

Discussion: primary lesions with acutely occurring both local and general body reactions lead to severe intoxication, which does not allow to exclude acute surgical pathology, and in some cases dictate the need for urgent surgical intervention.

Differential diagnosis of an amoeba with a colon cancer only on the basis of x-ray symptoms is almost impossible. Specific anti-ameba therapy leads to the disappearance of amoeba.

Conclusion: only on the basis of a complex of clinical and epidemiological data, ultrasound, CT, colonoscopy, histological analysis and parasitological methods of research, pathology can be correctly identified.

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