Invasive amoebiasis: an unusual presentation.

A 63 year old Asian woman who presented with three week's abdominal pain was found to have a hard right iliac fossa mass and rectal ulceration. Profuse rectal bleeding necessitated a laparotomy. An inflammatory paracaecal mass with fistulae involving appendix, small bowel, and bladder was excised with exteriorisation of the bowel ends. Microscopy showed invasive amoebae. Re-anastomosis was successfully done after treatment with metronidazole and diloxanide. There are no previous reports of a paracaecal amoeboma with fistulae to either the appendix, or urinary bladder.