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Right abdominal mass: keep an open mind.

Mishra A, Azzabi M, Hamadto M, Mishra J, Bugren S, Hresha W, Addalla S, Ehtuish EF - Libyan J Med (2010)

Bottom Line: Amebic colitis is common in tropics, usually presenting with variable and non-specific symptoms.This report describes the case of a 27-year-old male who presented with right abdominal mass.Amebic colitis should be considered as a possible diagnosis when dealing with right-sided abdominal mass.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, National Organ Transplant Centre, Tripoli, Libya.

ABSTRACT
Amebic colitis is common in tropics, usually presenting with variable and non-specific symptoms. Amebomas occur rarely, usually in cecum and ascending colon, when they can masquerade as colon carcinoma. This report describes the case of a 27-year-old male who presented with right abdominal mass. Radiological examination prompted us to the differential diagnosis of ameboma and he was treated with metronidazole and broad-spectrum antibiotics for two weeks. Amebic colitis should be considered as a possible diagnosis when dealing with right-sided abdominal mass.

No MeSH data available.


Related in: MedlinePlus

a and b: Axial (a) and reformatted coronal; (b) CT scan images show the concentric irregular colonic wall thickening with multiple mesenteric nodes.
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Figure 0003: a and b: Axial (a) and reformatted coronal; (b) CT scan images show the concentric irregular colonic wall thickening with multiple mesenteric nodes.

Mentions: A 27-year-old man was admitted to the surgical department with right abdominal mass of 10 days' duration associated with abdominal distension, fever, and constipation. There was no preceding diarrhea or bleeding per rectum. His medical history was unremarkable. Physical examination revealed a mildly tender right abdominal mass. Digital rectal examination was normal. A working diagnosis of colon cancer was made. Abdominal X-ray revealed dilated small bowel loops (Fig. 1), while blood tests showed marked leucocytosis (white cell count 15×103/dL). Liver function test and tumor markers (alpha-feto protein and chorioembryonic antigen) were normal. Ultrasound showed a complex bowel mass in relation to cecum and ascending colon with typical ‘whorl’ appearance (Fig. 2). Computed tomographic (CT) scanning of the abdomen confirmed an ascending colon mass with inflammatory changes (Fig. 3). No focal liver lesion was detected. Radiological findings prompted the surgeons to investigate for amebic etiology and ameboma was considered a more probable diagnosis. Stool microscopic examination revealed ova of Entameba histolytica thereby confirming the diagnosis of ameboma and the patient was put on broad spectrum antibiotic (Augmentin 1 gm) and metronidazole. His general condition improved dramatically over 72 hours, when he became afebrile and the abdominal mass showed signs of regression. A follow-up CT scan after two weeks of treatment showed almost complete resolution (Fig. 4).


Right abdominal mass: keep an open mind.

Mishra A, Azzabi M, Hamadto M, Mishra J, Bugren S, Hresha W, Addalla S, Ehtuish EF - Libyan J Med (2010)

a and b: Axial (a) and reformatted coronal; (b) CT scan images show the concentric irregular colonic wall thickening with multiple mesenteric nodes.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3066772&req=5

Figure 0003: a and b: Axial (a) and reformatted coronal; (b) CT scan images show the concentric irregular colonic wall thickening with multiple mesenteric nodes.
Mentions: A 27-year-old man was admitted to the surgical department with right abdominal mass of 10 days' duration associated with abdominal distension, fever, and constipation. There was no preceding diarrhea or bleeding per rectum. His medical history was unremarkable. Physical examination revealed a mildly tender right abdominal mass. Digital rectal examination was normal. A working diagnosis of colon cancer was made. Abdominal X-ray revealed dilated small bowel loops (Fig. 1), while blood tests showed marked leucocytosis (white cell count 15×103/dL). Liver function test and tumor markers (alpha-feto protein and chorioembryonic antigen) were normal. Ultrasound showed a complex bowel mass in relation to cecum and ascending colon with typical ‘whorl’ appearance (Fig. 2). Computed tomographic (CT) scanning of the abdomen confirmed an ascending colon mass with inflammatory changes (Fig. 3). No focal liver lesion was detected. Radiological findings prompted the surgeons to investigate for amebic etiology and ameboma was considered a more probable diagnosis. Stool microscopic examination revealed ova of Entameba histolytica thereby confirming the diagnosis of ameboma and the patient was put on broad spectrum antibiotic (Augmentin 1 gm) and metronidazole. His general condition improved dramatically over 72 hours, when he became afebrile and the abdominal mass showed signs of regression. A follow-up CT scan after two weeks of treatment showed almost complete resolution (Fig. 4).

Bottom Line: Amebic colitis is common in tropics, usually presenting with variable and non-specific symptoms.This report describes the case of a 27-year-old male who presented with right abdominal mass.Amebic colitis should be considered as a possible diagnosis when dealing with right-sided abdominal mass.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, National Organ Transplant Centre, Tripoli, Libya.

ABSTRACT
Amebic colitis is common in tropics, usually presenting with variable and non-specific symptoms. Amebomas occur rarely, usually in cecum and ascending colon, when they can masquerade as colon carcinoma. This report describes the case of a 27-year-old male who presented with right abdominal mass. Radiological examination prompted us to the differential diagnosis of ameboma and he was treated with metronidazole and broad-spectrum antibiotics for two weeks. Amebic colitis should be considered as a possible diagnosis when dealing with right-sided abdominal mass.

No MeSH data available.


Related in: MedlinePlus