Ameboma en anastomosis de bypass gástrico: Reporte de Caso

Abstract

Entamoeba histolytica is a parasite that infects between 30 and 50 million people and is responsible for around 100,000 deaths annually, predominantly in developing countries where it is endemic. The infection may be asymptomatic; however, in a small percentage, it can cause serious complications, such as ameboma—an inflammatory mass in the colon that presents with symptoms such as fever and abdominal pain and sometimes simulates an intestinal obstruction. Diagnosis requires paraclinical examinations and imaging, followed by treatment with metronidazole. In gastric bypass patients, detection and treatment can be challenging due to underreporting and recurrence. A clinical case is described by a 36-year-old male patient with a history of hypertension, diabetes, obesity, and bariatric surgery, who developed a clinical picture similar to intestinal obstruction after gastric bypass. Studies, including computed tomography, revealed a thickening of the ascending colon caused by an ameboma, diagnosed by pathological analysis in a sample obtained during a right hemicolectomy. Management was surgical due to the incidental finding, supported by the use of antibiotics and nitroimidazoles, resulting in the patient's favorable recovery. This case describes the unusual manifestations of amebiasis in a postsurgical context, providing relevant data on infectious complications in surgical sites—phenomena rarely reported in the medical literature—which creates the need for the development of specific protocols for the management of infections with characteristics similar to the case.