exudates and Colonic-Diseases

Amebiasis is a frequently occurring parasitic infection in South East Asia. We present a case of a 54-year-old man with right lower quadrant abdominal pain that persisted for longer than 1 year. He had been diagnosed with inflammatory bowel disease in Indonesia. His abdominal pain persisted, despite therapy, and he visited Malaysia for transnational medical advice. Abdominal ultrasound showed fatty liver, gallbladder polyps, and a small left renal stone. Colonoscopy showed multiple ulcers in the cecum and a histopathological examination confirmed amebic infection of the cecum. The colonic ulcers subsided after anti-amebic treatment. This case highlights the need to consider the differential diagnosis of amebic colitis in patients presenting with manifestations of inflammatory bowel disease, especially in patients who live in or have traveled to endemic areas.

Topics: Abdominal Pain; Amebiasis; Cecum; Colonic Diseases; Colonoscopy; Diagnosis, Differential; Dysentery, Amebic; Humans; Inflammatory Bowel Diseases; Malaysia; Male; Middle Aged; Ulcer; Ultrasonography

Adult intussusception is rare. It represents only 5% of all intussusceptions and 1% of bowel obstruction. Clinical presentations are usually variable with a variety of acute, intermittent and chronic symptoms. It is associated with an underlying pathologic process in 90% of cases. A lack of Malaysia data prompted review of the Sarawak experience with this uncommon entity, focusing on the clinical features, diagnostic procedure and treatment. During the last 5 years, there were 14 cases of surgically proven adult intussusception. Mean age was 45.9 years. There were 9 enteric and 5 colonic intussusceptions. Ninety-three percent of the intussusceptions were associated with a pathologic lesion. Thirty-three percent of the enteric lesions were malignant and 67% were benign. Eighty percent of the colonic lesions were malignant and 20% were benign. Computed tomography scan has a good diagnostic accuracy of 83% and should be considered for all patients with nonspecific abdominal symptoms or suspected bowel obstruction. Treatment of choice for colonic intussusception in adults is en bloc resection without reduction whenever possible, whereas a more selective approach for enteric lesions.

Topics: Adult; Aged; Colonic Diseases; Female; Humans; Intussusception; Malaysia; Male; Middle Aged; Retrospective Studies; Young Adult

This paper describes the first Malaysian case of oesophagostomiasis. The patient was an 8-year-old Malay boy who presented to Ipoh General Hospital, Perak with abdominal pain and weight loss. Examination revealed multiple cavitated pseudotumours of the colon. A hemicolectomy was performed. Examination of the lesions revealed Oesophagostomum worms in the necrotic centres. The differential diagnoses and the pathology caused by Oesophagostomum are discussed. A brief review of the available literature is presented.

Topics: Animals; Child; Colonic Diseases; Humans; Intestinal Diseases, Parasitic; Malaysia; Male; Oesophagostomiasis; Oesophagostomum

Topics: Colon; Colon, Sigmoid; Colonic Diseases; Diagnosis, Differential; Diverticulitis, Colonic; Humans; Hydronephrosis; Intestinal Fistula; Malaysia; Male; Middle Aged; Radiography; Sigmoid Neoplasms; Urinary Bladder Fistula

Topics: Aged; Animals; Arthropods; Calcinosis; Colonic Diseases; Disease Vectors; Humans; Malaysia; Male; Parasitic Diseases; Radiography; Snakes; Thoracic Diseases