Massive Lower GI Bleeding: A Rare and Life-Threatening Presentation of Intestinal Amoebiasis
Himanshu Agrawal, Vidhi Maurya, Salamatullah Mobeen, Sanjay Gupta
Asian Journal of Research in Surgery · pp. 45–48 · Published 12 Mar 2025
10.9734/ajrs/2025/v8i1262Abstract
Amoebiasis is responsible for around 40,000–100,000 mortalities per year globally and is among the top four causes of death from protozoan infections. Entamoeba histolytica is recognized as a pathogenic amoeba and is associated with both intestinal and extraintestinal manifestations. It has diverse pathogenic mechanisms that cause tissue damage, leading to ulcers and/or abscesses. Intestinal amoebiasis can have a very rare presentation of life-threatening, massive lower gastrointestinal bleeding without diarrhea. We report a case of a male in his late 40s who presented with pain in the right upper abdomen and massive lower gastrointestinal bleeding, subsequently diagnosed with a caecal ulcer as a manifestation of intestinal amoebiasis, along with a liver abscess as an extraintestinal manifestation. Radiological evaluation revealed a right lobe liver abscess with anchovy sauce content on drainage and active contrast extravasation at the cecum. Exploratory laparotomy with right hemicolectomy was performed, and multiple caecal ulcers were present.
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