Ileocecal masses in patients with amebic liver abscess: etiology and management.
OBJECTIVE
To assess the causes of ileocecal mass in patients with amebic liver abscess.


METHODS
Patients with amebic liver abscess and ileocecal mass were carefully examined and investigated by contrast-enhanced CT scan followed by colonoscopy and histological examination of biopsy materials from lesions during colonoscopy.


RESULTS
Ileocecal masses were found in seventeen patients with amebic liver abscess. The cause of the mass was ameboma in 14 patients, cecal tuberculosis in 2 patients and adenocarcinoma of the cecum in 1 patient. Colonic ulcers were noted in five of the six (83%) patients with active diarrhea at presentation. The ileocecal mass in all these patients was ameboma. Ulcers were seen in only one of the 11 (9%) patients without diarrhea. The difference was statistically significant from the group with diarrhea (P< 0.005).


CONCLUSIONS
Ileocecal mass is not an uncommon finding in patients with amebic liver abscess. Although, the ileocecal mass is due to ameboma formation in most cases, it should not be assumed that this is the case in all patients. Colonoscopy and histological examination of the target biopsies are mandatory to avoid missing a more sinister lesion.
Misra
Sri Prakash
SP
Department of Gastroenterology, Moti Lal Nehru Medical College, Allahabad 211 001, India. spmisra@sancharnet.in
Misra
Vatsala
V
Dwivedi
Manisha
M
D000328:Adult; D000818:Animals; D001706:Biopsy; D002429:Cecal Diseases / Q000150:complications* / Q000175:diagnosis; D003113:Colonoscopy; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000150:complications* / Q000175:diagnosis; D008101:Liver Abscess, Amebic / Q000150:complications*; D008297:Male; D008875:Middle Aged