<![CDATA[Hematochezia in diverticulosis is due to vascular rupture at the base of the diverticulum. Concomitant amoebiasis causecolonic mucosal ulceration leading to colitis and severe bleeding, may developing perforated colon. This combination israrely reported and pose a diagnostic challenge due to overlapping symptoms. Hematochezia in a patient withdiverticulosis caused by “hidden” amoebiasis was reported. It is important to be alert amoebiasis among patients withdiverticulosis and lower intestine bleeding. An 83-year-old man with a history of diverticulosis 10 years ago complains offresh bloody diarrhea of 400 cc each time. Concomitant complaints; sweating and weakness. Examination; anemicconjunctiva, epigastric tenderness, increased bowel sounds, and cold acral. Blood tests; severe anemia (hemoglobin,6g/dL), CRP and PCT level were 9.44 mg/L and 4.37 ng/mL respectively, suggesting a high risk of sepsis. Endoscopy;Diverticula along the sigmoid to transverse colon, sigmoid erosion. Contrast abdominal CT; diverticulosis along thecolon. Feces examination; mucus, erythrocytes, amoeba, and leukocytes. The results indicate diverticulosis andamoebiasis. Blood culture showed gram-negative Pseudomonas. The patient was treated with intravenous fluids,anti-amoeba therapy, and blood transfusions. His condition improved, and he was discharged after 16 days with normalbowel movements, resolved tenderness, hemoglobin level of 10.2 g/dL, and normal macroscopic and microscopic findingof feces. This case illustrates that amoebiasis can be a hidden and serious cause of hematochezia in patients withdiverticulosis. Early recognition and comprehensive management, including hemoglobin monitoring, antiamoebictreatment, and transfusion, are critical for improved outcomes]]>
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