Amoebic perforation of the bowel.

In a 20-month period 6 patients with amoebic perforation of the bowel were seen in the pathology department at Baragwanath Hospital. The duration of the disease was short, and the diagnosis was made pre-operatively in only 2 cases. All the patients had total colitis with multiple ulcers, and in 2 there was involvement of the terminal ileum. Single perforations were present in 2 cases and multiple perforations in the remaining 4. All the patients had fibrinous peritonitis and none had an associated liver abscess. Partial or total colectomy was performed on 5 patients, 1 of whom survived. The operative management of amoebic colitis with perforation is discussed; diversion of the faecal stream with drainage is recommended when possible.