Gastroenterologia y hepatologia · 2014
[Ameboma: possible therapeutic decisions in an amebiasis-endemic region].
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Villegas-Betanzo Pavel, Martínez-Jiménez Mario Aurelio, Guevara-Torres Lorenzo, Quintero-Meza Karla, Sánchez-Aguilar Martín, Arriaga-Caballero Jesús Emmanuel
Аннотация
INTRODUCTION: Amebiasis can mimic cecal tumors. Unless this infection is diagnosed in a timely manner, affected individuals may undergo extensive surgery.
MATERIAL AND METHODS: We carried out a retrospective analytical study of the therapeutic approach to amebiasis in a second-level hospital in an area of central Mexico with a high prevalence of this infection. Records from 2005-2011 were reviewed. There were 261 cases of amebiasis. Twenty cases were diagnosed by the histopathologist or on the basis of serological results. Sixteen patients underwent surgery due to acute abdomen, and four received medical treatment with metronidazole. Three treatment groups were analyzed: 1. hemicolectomy, 2. appendicectomy and antiamebic therapy, and 3. antiamoebic therapy alone. In the non-surgical group, imaging studies showed improvement with medical therapy.
RESULTS: Length of hospital stay was higher in the group undergoing extensive surgery (p < 0.0133). There were no statistically significant differences among the remaining variables.
CONCLUSIONS: The incidence of ameboma in our environment is higher (7.6%) than that reported in the literature. We believe that, in endemic regions, ameboma should be ruled out in patients with a cecal mass. As part of the therapeutic approach, patients should be tested for amebiasis or receive antiamebic therapy with monitoring of the mass to avoid extensive resective surgery.
MATERIAL AND METHODS: We carried out a retrospective analytical study of the therapeutic approach to amebiasis in a second-level hospital in an area of central Mexico with a high prevalence of this infection. Records from 2005-2011 were reviewed. There were 261 cases of amebiasis. Twenty cases were diagnosed by the histopathologist or on the basis of serological results. Sixteen patients underwent surgery due to acute abdomen, and four received medical treatment with metronidazole. Three treatment groups were analyzed: 1. hemicolectomy, 2. appendicectomy and antiamebic therapy, and 3. antiamoebic therapy alone. In the non-surgical group, imaging studies showed improvement with medical therapy.
RESULTS: Length of hospital stay was higher in the group undergoing extensive surgery (p < 0.0133). There were no statistically significant differences among the remaining variables.
CONCLUSIONS: The incidence of ameboma in our environment is higher (7.6%) than that reported in the literature. We believe that, in endemic regions, ameboma should be ruled out in patients with a cecal mass. As part of the therapeutic approach, patients should be tested for amebiasis or receive antiamebic therapy with monitoring of the mass to avoid extensive resective surgery.