Acute fulminant necrotizing amoebic pancolitis: A lethal entity in children

Abstract

A 4-year-old boy presented in a state of septicemic shock, disoriented with peritonitis, and marked hemodynamic instability. The child was resuscitated; radiographs confirmed pneumoperitoneum. Intraoperatively, there were multiple perforations with necrotic changes in the entire colon up to the rectum, suggestive of acute fulminant necrotizing pancolitis. He was managed by total colectomy, ileostomy, with Hartman's pouch. Histopathology confirmed necrotizing amoebic pancolitis. Postoperatively, administration of metronidazole with broad-spectrum antibiotic coverage, hyperalimentation, and multiple platelet concentrates was given. The child had profound immunosuppression and expired due to multiple organ dysfunction syndrome. Acute fulminant necrotizing amoebic pancolitis is an extremely lethal entity in children.

Keywords

• Acute fulminant
• children
• necrotizing amoebic pancolitis
• perforation
• total colectomy