Synchronus Ameboma Invater Ampulla and Colon First Case Reported in Literature

nbsp nbsp nbsp nbsp nbsp nbsp nbsp nbsp nbsp nbsp nbsp nbsp Aim An inflammatory and proliferative response to amibiasis infection is known as ameboma a pseudotumoral lesion the ascendant colon is the most frequent location nbsp nbsp nbsp nbsp nbsp nbsp nbsp nbsp nbsp nbsp nbsp nbsp Case report A male of years old referring diarrhea and epigastric pain comes to emergency room At physical exam with tachycardia tachypnea abdominal pain located in epigastrium right iliac fossae and rebound sign Laboratories report leukocytosis neutrophilia and eosinophilia Abdominal ultrasound reports a paracecal abscess probably secondary to acute appendicitis Laparotomy was performed finding an infiltrating tumoral lesion in ascendant colon with perforation and abscess extended to the duodenum and another tumoral lesion in Vater ampulla A right extended hemicolectomy was performed with oncological approach and after hours in the Intensive Care Unit Whipple procedure was completed Patient developed amebic colitis with sigmoidal perforation and a subtotal colectomy was completed After medical treatment patient presents multiple organic failure and died at th day Histopathological exam reports Vater ampulla ameboma with extension to pancreas right colon ameboma and ulcerative amibiasis in colon nbsp nbsp nbsp nbsp nbsp nbsp nbsp nbsp nbsp nbsp nbsp nbsp Conclusion At our knowledge this is the first reported case of Vater ampulla ameboma in literature The diagnosis of this lesions are difficult inclusive after CT scan but it can be treated medically It must be considered in the differential diagnosis of colonic tumors and in case of suspect in an acute abdomen scenario the source must be treated and resection avoided if possible