An Interesting Presentation of Ameboma – A Case Report and Review of Literature

Abstract

Objectives:To compare small bowel distension and bowel wall visualization among three different patients' positions (supine, sitting and right decubitus) during administration of oral contrast media in preparation for CT enterography (CTE). Methods:A total of 150 consecutive patients (104 males and 46 females; mean age 34.6 years, range 15-78 years) who were scheduled to undergo CTE were recruited. Patients were randomly allocated into the three position groups during oral contrast media administration, and there were 50 patients in each group. Two blinded radiologists independently scored the luminal distension and visualization of the bowel wall using a continuous 5-point scale (1: worst and 5: best) at the jejunum and ileum. The Mann-Whitney U test was used to evaluate differences between any two groups among the three positions for bowel distension and wall visualization.Results: For ileal distension, the supine and sitting positions performed better than the right decubitus position [for reader 1, mean: 3.4/3.2/2.9 (hereafter, supine/sitting/ right decubitus in order), p = 0.002/0.033; for reader 2, 3.3/3.0/2.6, p < 0.001/0.027]. However, there was no significant difference among the three groups for jejunal distension (for reader 1, 2.4/2.3/2.2; for reader 2, 2.4/2.4/2.2, p > 0.05, respectively). For bowel wall visualization, the supine and sitting positions were superior to the right decubitus position for the ileum when scored by one reader (4.0/3.8/3.4, p = 0.001/0.015).Conclusion: Supine and sitting positions during the administration of oral contrast media provided better ileal distension than the right decubitus position in obtaining CTE.

Amoebic Colitis Presenting as Subacute Intestinal Obstruction with Perforation

“…Amebomas are due to repeated episodes of untreated or partially treated amebic colitis which emphasizes the importance of early diagnosis of amoebic colitis. Serious complications like fulminant necrotizing colitis, toxic megacolon, and fistulizing perianal ulcerations are presented when diagnosis and treatment is not done timely [8,11].…”