PMC7439188_01
Chest X-ray showing gas under diaphragm.
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fig1
After stabilization, the patient was shifted for chest and abdominal X-ray, which showed gas under the diaphragm (Figure 1).
(a) Resected bowel segment showing the gangrenous ascending colon (dashed arrow) and sloughed off caecum (bold arrow). (b) Resected transverse colon with mesocolon (gangrenous with multiple perforations).
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fig2
The caecum was found to be gangrenous and had sloughed off (Figure 2) and there were multiple perforations in the ascending colon and transverse colon.
Resected descending colon showing multiple perforations (arrows).
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Gross examination of the resected colectomy specimen showed sloughed off caecum with multiple perforations in the ascending, transverse, and descending colon (Figure 3).
Opened up descending colon showing multiple areas of sloughed off mucosa with necrosis and perforation.
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fig4
On cut section examination, there were patchy segments of extensive transmural necrosis with multiple defects ranging from 0.5-2 cm throughout the large bowel (Figure 4).
H&E stained tissue from ulcer from the resected specimen of the colon; arrow indicates trophozoites of E. histolytica.
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fig5
The colonic mucosal ulcers were covered with neutrophilic debris within which E. histolytica were identified (Figure 5).
Periodic acid-Schiff (PAS) positive amoebic trophozoites.
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Periodic acid-Schiff staining was positive (Figure 6).