Next Page

Imaging Diagnosis

The radiological findings in amebiasis are many and varied. The radiologist, like the clinician, must have a high index of suspicion to suggest the correct diagnosis.

Intestinal Amebiasis

Plain radiographs of the abdomen.

Abdominal films are of little value in the diagnosis of ulcerative amebic proctocolitis unless a perforation has occurred. They are of paramount importance in assessing the grave form of amebiasis, such as fulminant colitis which co-exists frequently with an ameboma (25%) and hepatic abscess (30%) (Fig. 1.12A). Gas in the colon serves as a natural contrast to outline alterations in the intestinal wall in patients with fulminant amebic colitis: 1) There may be a nonspecific pattern of right lower quadrant haziness with minimal colonic distension. 2) Thumbprinting may be present with deep indentations on the distended colon, segmental or generalized, predominantly in the transverse colon (Fig. 1.12B). Thumbprinting represents areas of extensive edema and necrosis and is indistinguishable from the thumbprinting seen in ischemic colitis and other hemorrhagic or edematous processes.

..

Fig. 1.12. Fulminant amebic colitis on plain film examination. (A) Note a diffuse antimesenteric ameboma narrowing the lumen of the proximal transverse colon. The distal transverse colon and several loops of small bowel in the mid-abdomen are distended, representing an ileus from peritoneal irritation. Opaque granular material represents ingested iodine-containing medication. (B) There is marked thumbprinting involving the transverse colon of another patient.

Back to the Table of Contents

Copyright: Palmer and Reeder
Tropical Medicine Mission Index of Diseases About Tropical Medicine Tropical Medicine Home Page Tropical Medicine Staff