Surgical Treatment of Chronic Amebic Colitis Mehmet Ozdogan, MD, Atac Baykal, MD, Burak Kavuklu, MD, Omer Aran, MD Department of General Surgery, Hacettepe University Medical School, Sihhiye, PK: 06100 Ankara, Turkey Published Online: September 8, 2005 Abstract There are limited data concerning the surgical management of chronic amebic colitis (CAC) in the literature. We present our experience with 10 patients with CAC treated surgically. Patients’ records were retrospectively analyzed for age, sex, duration of clinical manifestations, colono- scopic findings, the type of surgical operation, and the postoperative course. Total proctocolec- tomy and J-pouch construction was performed in two patients who had CAC with severe rectal involvement. Total colectomy and the Hartmann procedure was performed in eight patients with mild to moderate rectal involvement. This treatment was successful in preserving the rectum in four of the eight. Our results suggest that rectal preservation can be a reliable treatment option in patients with CAC who have mild to moderate rectal involvement. Total proctocolectomy and ileoanal anastomosis with pouch construction should be the treatment of choice for patients with CAC who have severe rectal involvement. A mebiasis is a parasitic disease caused by Entamoeba histolytica (EH). Although it is primarily an infection of the large bowel, it may spread hematogenously to other organs. The organism is found worldwide, but its preva- lence is particularly high in the tropics and in areas where sanitation is suboptimal. The disease may present in an acute or a chronic form. About 90% of infections are asymptomatic, whereas the remaining 10% produce a spectrum of clinical disorders ranging from dysentery to abscess of the liver or other organs. 1,2 Medical treatment is successful most of the time in the symptomatic group. Differential diagnosis of chronic amebic colitis (CAC) from inflammatory bowel diseases, especially ulcerative colitis (UC), is not easy. Moreover, not uncommonly, the two diseases might be found together, adding to the complexity of the disease. Surgical management of chronic amebic colitis is a complicated and controversial issue. Our pur- pose in this study was to present our experience with surgical treatment of CAC to provide data for the man- agement of this rare entity. MATERIALS AND METHODS Between 1985 and 2003, ten patients were operated on because of CAC at Hacettepe University Medical School, Department of General Surgery. Clinical records of the patients were analyzed retrospectively. Patients’ medical records were reviewed for age, sex, duration of clinical manifestations, presence of other systemic diseases, proc- toscopic or colonoscopic findings, biochemical data, duration of medical treatment, preoperative transfusion requirements, the type of surgical operation, and the postoperative course. RESULTS There were four female and six male patients with a mean age of 42 years. Presenting symptoms were mucous or bloody diarrhea, abdominal pain, and weight loss. Duration of symptoms was more than 12 months in all of the patients. Preoperatively, EH cysts were identified in stool samples, and trophozoites were identified by colonoscopic biopsies Correspondence to: Mehmet Ozdogan, MD, Mertlersok. 14/7, PK: 06510 Bestepe, Ankara, Turkey, e-mail: mehmetozdogan01@superonline.com World Journal of Surgery 2005 World J Surg (2005) 29: 1440–1443 Published Online: 1 October 2005 DOI: 10.1007/s00268-005-0169-8