Surgical intervention in intestinal amebiasis.

Operative intervention in patients with unrecognized and untreated amebomas or acute fulminating amebic colitis may result in severe complications. Nevertheless, certain clinical presentations of intestinal amebiasis require surgical procedures varying from drainage of an abscess to a subtotal colectomy. If, in patients with acute fulminating amebic colitis, the signs or symptoms of intraperitoneal or impending perforation develop, unremitting diarrhea associated with anemia and hypoproteinemia continues, or localized abscsses fail to improve with chemotherapy, operative intervention is indicated. Complications of amebomas that require operative intervention include failure to respond to chemotherapy, perforation, hemorrhage, ulceration, stricture or fistula formation and obstruction. Anti-amebic chemotherapy can reduce intestinal complications so elective operative procedures should be delayed to allow time for adequate treatment.