Amoebic colitis presenting as ileocaecal intussusception - a rare case

Area of Science:

• Gastroenterology
• Tropical Medicine
• Surgical Pathology

Background:

• Ileocecal intussusception is a frequent cause of acute intestinal obstruction, often requiring emergency surgery.
• Amoebic colitis is a potential, though rare, etiology for intussusception, particularly in tropical areas.
• Distinguishing amoebic colitis from idiopathic intussusception is crucial for appropriate management and preventing recurrence.

Purpose of the Study:

• To report a rare case of ileocecal intussusception secondary to amoebic colitis.
• To highlight the importance of considering amoebic colitis in the differential diagnosis of intussusception in endemic regions.
• To emphasize the need for awareness among tropical surgeons regarding this specific etiology.

Main Methods:

• Case report of a 62-year-old male presenting with acute right iliac fossa pain and constipation.
• Diagnostic workup included physical examination, ultrasound (revealing free fluid and a loop-within-loop image), and subsequent laparotomy.
• Post-operative diagnosis confirmed by serology and pathology for invasive amoebic infection.

Main Results:

• Laparotomy revealed ileocecal intussusception with a gangrenous caecum.
• A right hemicolectomy was successfully performed, with a satisfactory patient outcome.
• Post-operative investigations confirmed amoebic colitis as the underlying cause.

Conclusions:

• Amoebic colitis should be considered in the differential diagnosis of ileocecal intussusception, especially in tropical regions.
• Failure to identify invasive amoebic infection can lead to misdiagnosis of intussusception as idiopathic.
• Early identification and treatment of amoebic colitis may reduce the incidence of recurrent intussusception.