Colonoscopic diagnosis of amebiasis

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See discussions, stats, and author profiles for this publication at: Colonoscopic diagnosis of amebiasis: a case series and systematic review Article in International Journal of Colorectal Disease · October 2014 Impact Factor: 2.45 · DOI: 10.1007/s00384-014-2040-6 · Source: PubMed CITATIONS 2 READS 92 5 authors , including: Kochao Lee Chang Gung Memorial Hospital 17 PUBLICATIONS 36 CITATIONS SEE PROFILE Bruce Lu Kaohsiung Medical University 29 PUBLICATIONS 1,839 CITATIONS SEE PROFILE All in-text references underlined in blue are linked to publications on ResearchGate, letting you access and read them immediately. Available from: Kochao Lee Retrieved on: 18 July 2016
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ORIGINAL ARTICLE Colonoscopic diagnosis of amebiasis: a case series and systematic review Ko-Chao Lee & Chien-Chang Lu & Wan-Hsiang Hu & Shung-Eing Lin & Hong-Hwa Chen Accepted: 9 October 2014 /Published online: 28 October 2014 # Springer-Verlag Berlin Heidelberg 2014 Abstract Purpose Nonspecific gastrointestinal symptoms make diag- nosis of amebiasis difficult. Certain colonoscopic findings predict amebic colitis while others suggest different diagno- ses. We aimed to evaluate the diagnostic capability of colonic evaluation of amebiasis. Methods We retrospectively reviewed data of all amebiasis cases admitted to our institution between 2003 and 2012. Cases were diagnosed by clinical presentation, laboratory examinations, and colonoscopy with biopsy and microscopic examination. Patients were stratified as right-sided colitis and proctosigmoiditis. A systematic review was conducted by searching Medline, Cochrane, EMBASE, and Google Scholar using key words amebiasis, amebic colitis, amebic proctosigmoiditis, colonoscopy, and Entamoeba histolytica. Data were extracted from articles meeting the inclusion criteria. Colonoscopic findings were described and studies were assessed for quality. Results The current series included 20 patients (5 male, 15 female, median age 51), 7 with amebic liver abscess and 13 with amebic colitis. Colonoscopic findings of right-sided co- litis included aphthae or erosions, ulcers, exudates, or edem- atous swollen mucosa in cecum, and findings for proctosigmoiditis were edematous swollen mucosa with bloody exudate. In 25 studies, colonoscopic findings of 41 patients (36 male, 5 female, median age 43.39 years) included mainly ulcers in the cecum and rectum, ulcerated mass, and edematous mucosa; and in fewer patients, submucosal inva- sion suggestive of colon cancer, bleeding ulcers, proctitis, and ulcers with aphthae in rectum. Conclusions Colonic evaluation of suspected amebiasis is of diagnostic value when accompanied by biopsy and micro- scopic identification of Entamoeba species. Colonoscopic manifestations vary between right-sided colitis and proctosigmoiditis.
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