내시경 소견으로 진단된 아메바성 대장염의 임상 양상
Clinical Characteristics of Amebic Colitis as Diagnosed by using Colonoscopic Findings
문규, 박종범, 백창희, 허장, 장희철, 김현식, 박영희, 이중달,
소속 상세정보
문규 ( Moon Gyoo )
송도병원 소화기내시경센터
박종범 ( Park Jong-Beom )
경희대학교 의과대학 내과학교실
백창희 ( Paik Chang-Hee )
송도병원 소화기내시경센터
허장 ( Hur Chang )
송도병원 소화기내시경센터
장희철 ( Jang Hee-Chul )
송도병원 소화기내시경센터
김현식 ( Kim Hyun-Shig )
송도병원 소화기내시경센터
박영희 ( Park Young-Hee )
송도병원 병리과
이중달 ( Lee Jung-Dal )
송도병원 병리과
KMID : 0356720060220060357
Abstract
Purpose: Nowadays, with improvements in hygiene and in the sewage system, the prevalence of amebic colitis in Korea is declining. However, amebic colitis still occurs every year. We investigated the clinical features of current patients with amebic colitis and compared the results with those for a past endemic period in Korea.
Methods: From June 2000 to June 2005, 10 patients were diagnosed in the Digestive endoscopy center of Song Do colorectal hospital as having amebic colitis. We evaluated their medical histories, clinical characteristics, and colonoscopic findings.
Results: The male-to-female ratio was 1.5：1. The mean age was 38.4±11.4 years. The mean diagnostic period from occurrence of symptoms to diagnosis was 20.4±17.5 days. The clinical symptoms of amebic colitis were diarrhea (80%), bloody stool (70%), mucoid stool (60%), abdominal pain (50%), fever, weight loss, nausea, and fatigue. Seven patients (70%) had a history of travel, and six of those seven patients had taken trips abroad. The foreign areas of travel included India (50%), Indonesia (28.6%), and Japan (16.7%). The diagnostic methods were colonoscopic biopsies to detect trophozoites of Entameba histolytica (90%) and serologic tests for the anti-ameba antibody (10%). The most common colonic locations of the lesions were the cecum (80%) and the rectum (80%). Another was the ascending colon (30%); pan-colonic involvement was also seen (10%).
Conclusion: In the past, the cause of amebic colitis in Korea was poor hygiene. Nowadays, however, travel to amebiasis-endemic areas may be the most important cause. Therefore, the travel history of diarrheal patients is an important diagnostic factor in cases of amebic colitis and a differential diagnosis factor in cases of inflammatory bowel disease. J Korean Soc Coloproctol 2006;22:357-362
키워드
아메바성 대장염;여행력;염증성 장질환
Amebic colitis;Travel history;Inflammatory bowel disease
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