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Related Experiment Videos

Appendicitis in acquired immunodeficiency syndrome.

T M Whitney1, J R Macho, T R Russell

  • 1Department of Surgery, University of California, San Francisco 94143-0807.

American Journal of Surgery
|November 1, 1992
PubMed
Summary

Appendicitis in patients with acquired immunodeficiency syndrome (AIDS) presents diagnostic challenges. Early surgical intervention and advanced imaging are recommended for better outcomes in these complex cases.

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Area of Science:

  • Surgery
  • Infectious Diseases
  • Gastroenterology

Background:

  • Surgical literature lacks data on common intra-abdominal diseases in patients with acquired immunodeficiency syndrome (AIDS).
  • Existing research on appendicitis in AIDS patients is limited, with high perforation rates and diagnostic difficulties.
  • Focus has been on AIDS-related intra-abdominal conditions, often requiring surgery only when complicated.

Purpose of the Study:

  • To review appendicitis cases in patients with AIDS.
  • To analyze diagnostic challenges and outcomes.
  • To evaluate the utility of preoperative symptoms and signs in differentiating appendicitis types.

Main Methods:

  • Literature review of appendicitis in AIDS patients (30 cases from 13 studies).

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  • Retrospective review of 28 patients with appendicitis and AIDS over 7 years from 4 urban hospitals.
  • Analysis of preoperative symptoms, signs, diagnostic imaging, and surgical outcomes.

    • Main Results:

    • Literature review showed a 40% perforation rate in appendicitis among AIDS patients.
    • The 7-year hospital review reported no perioperative deaths and an 18% postoperative complication rate.
    • 18% of patients had normal appendices with other pathologies; 30% had AIDS-related appendicitis.
    • No preoperative symptom or sign reliably differentiated AIDS-related from non-AIDS-related appendicitis, except for diffuse vs. localized pain.

    Conclusions:

    • Appendicitis in AIDS patients often presents with diagnostic delays and errors.
    • Advanced imaging (ultrasound, CT scans) and early surgical intervention are crucial.
    • Aggressive diagnostic and therapeutic approaches are recommended for improved patient management.