Intestinal amoebiasis is a parasitic infection caused by Entamoeba histolytica. It is commonly found in developing countries with poor hygiene. A rare, life-threatening complication of amoebiasis is fulminant necrotizing amoebic colitis (FulNAC). We report a 59-year-old male with acute lower right abdominal pain. Before coming to our institution, he was diagnosed with acute appendicitis. Extensive necrosis near the caecum involving the appendix and colon was observed intraoperatively. The patient underwent a right hemicolectomy, followed by an ileostomy and colostomy. Histopathologic examination confirmed the diagnosis of FulNAC. After the surgery, the patient was transferred to the high care unit and treated with metronidazole after histopathologic findings confirmed the etiology. The patient showed excellent response to the antibiotic prescribed, and the symptoms subsided. He was discharged from the hospital on day nine. Additionally, we reviewed fifty-one existing case reports on invasive intestinal amoebiasis worldwide, confirmed by histopathological examination following their preoperative diagnosis, surgery, pharmacology treatment, and outcomes. The learning point of this case is that intestinal amoebiasis should be considered a differential diagnosis for patients around fifty years old with bowel symptoms and travel history or living in tight quarters. Blood tests, radiological examinations, and serological evaluations are valuable diagnostic modalities. Metronidazole should be given as early as possible, and health promotion is recommended to prevent this disease in the population.

Highlights Determining the right time to do examination on pregnant patients with persistent gastrointestinal disturbances is still on debate. Gastric cancer should be suspected when epigastric/abdominal pain, nauseous, vomiting happen up to 2nd trimester. Additional examinations with lowest risk effects and optimal accuracy must be done to evaluate resectability. MRI is recommended for staging despite its low accuracy. Contrast abdominal CT scan can be done in pregnancy with consent. Surgery and chemotherapy are relatively safe in 2nd and 3rd trimester for their lower risk of malformation and abortion.

Introduction. The incidence and mortality of colorectal cancer (CRC) in young adults (below the age of 50 years) has been increased. However, there's no screening method for these cancer in those group of age because there is no scientifically proven risk factor. Thus, a meta-analysis carried out to find out the risk factor for CRC in young adults. Method. A Meta-analysis study was conducted in January 2017. Literature search addressed to the articles published during a period of 2007-2017 in Cochrane and PubMed using keywords: "young" AND "risk factor" AND "colorectal cancer" OR "colon cancer" or "rectal cancer". Inclusion criteria were the CRC prevalence, risk factor analysis for CRC incidence and young population (below 50 years old). The meta-analysis carried out through qualitative and quantitative approach. Results. In the last 10 years, there were twelve published articles met the criteria. Those were cohort study (an article), case-control study (four articles), and cross-sectional study (seven articles). Twenty-five risk factors were noted. The meta-analysis showed that gender (males) with OR = 1.66, 95% CI = (1.04-2.64); I2 = 93%), family history with OR = 2.01, 95% CI = (1.11-3.67); I2 = 78%), metabolic syndrome with OR = 1.80, 95% CI = (1.49-2.16), I2 = 0%), and smoking with OR = 1.57, 95% CI = (1.40-1.77), I2 = 4%) were the significant risk factors with the association of CRC. Conclusion. Young adults of males, with a family history of CRC, metabolic syndrome, and smoking were at the risk to have colorectal cancer.