The management and prognosis of fulminating amebic colitis

From 1977 to 1994 thirty-five patients diagnosed with fulminating amebic colitis were reviewed. All of them had undergone surgery within 48 hours after admission. Three different surgical procedures were chosen based on abdominal contamination and the lesion pattern. Group I: 13 cases, the surgical procedure was resection with anastomosis. Group II: 20 cases, the surgical procedure was resection without anastomosis. Group III: 2 cases, the surgical procedure was loop ileostomy diversion. The factors which may affect prognoses were studied, including age, duration of symptoms before surgery, surgical method, preoperative general condition and the degree of abdominal contamination during surgery, etcetera. The overall mortality rate was 34%. However, 83% of the dead were in Group II. Delayed surgery, poor preoperative general condition and severe abdominal contamination resulted in a worse prognosis. Resection without anastomosis is recommended if the degree of abdominal contamination is severe at surgery.