Amebic Colitis: A Case Series and Review in Taipei Veterans General Hospital

阿米巴性結腸炎：臺北榮民總醫院病例回顧分析

蘇俞豪(Yu-Hao Su) ； 林春吉(Chun-Chi Lin) ； 藍苑慈(Yuan-Tzu Lan) ； 張世慶(Shih-Ching Chang) ； 王煥昇(Huann-Sheng Wang) ； 楊純豪(Shung-Haur Yang) ； 姜正愷(Jeng-Kai Jiang) ； 陳維熊(Wei-Shone Chen) ； 林資琛(Tzu-Chen Lin) ； 林楨國(Jen-Kou Lin) ； 林宏鑫(Hung-Hsin Lin)

《中華民國大腸直腸外科醫學會雜誌》 28卷2期 (2017/06) Pp. 88-93

https://doi.org/10.6312/SCRSTW.2017.28(2).10526

摘要

Purpose. Amebic colitis caused by Entamoeba histolytica can range in severity from asymptomatic to life-threatening colitis. However, accurate diagnosis is difficult because of nonspecific symptoms. We aimed to evaluate diagnostic modalities and possible risk factors for amebic colitis in a case series. Methods. We reviewed patients with amebic colitis, with diagnosis proven by pathologic or serum testing, in Taipei Veterans General Hospital from January 2000 to December 2015. The symptoms, examinations, and treatment were reviewed and analyzed. Results. Eleven patients were included in this case analysis. The mean age was 51 years. The main symptoms were bloody stools, diarrhea, and abdominal pain. Nine patients underwent indirect hemagglutination assay (IHA), and all tested positive. Colonoscopy showed ulcers of variable sizes, predominantly in the rectum. Most pathology showed trophozoites with inflammation. Conclusions. Amebic colitis may present with variable nonspecific symptoms. Colonoscopy is a good diagnostic method when accompanied by biopsy for suspected amebiasis.

關鍵字

Amebic colitis ； Colonoscopy ； Diagnosis ； Entamoeba histolytica

並列摘要

目的 阿米巴性結腸炎的表現可從無症狀，到致命的結腸炎。然而，因為非特異性症狀，精準診斷阿米巴性結腸炎是很困難的。本篇文章目的是期待藉由臺北榮民總醫院的病例回顧分析，找出阿米巴性結腸炎可能的診斷工具以及危險因子。方法 本篇文章收集台北榮民總醫院從2000 年1 月到2015 年12 月診斷出阿米巴性結腸炎的病人，並且針對症狀、檢查、以及治療進行回顧和分析。結果 共有11 例病人納入本案例研究。平均年齡為51 歲。主要症狀為便血，腹瀉，腹痛。九名患者接受了間接血凝試驗 (IHA) 的測並皆呈現陽性反應。結腸鏡檢查多以大小不一的潰瘍作呈現，且主要的部位位於直腸。大多數切片病理都有發炎反應以及阿米巴滋養體。結論 阿米巴性結腸炎可能以不同非特異性症狀呈現。如果病人症狀懷疑是阿米巴疾病，結腸鏡加上切片檢查以及間接血凝試驗將是很好的診斷方法。

並列關鍵字

阿米巴性結腸炎 ； 結腸鏡 ； 診斷 ； 痢疾阿米巴

參考文獻

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