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The acute AIDS abdomen--a prospective clinical and pathological study
1Department of Surgery, University of the Free State, Bloemfontein.
South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
|September 27, 2005
Summary
The acute abdomen in patients with Acquired Immunodeficiency Syndrome (AIDS) presents unique challenges. Intestinal tuberculosis is a frequent cause, leading to high mortality rates, necessitating new treatment strategies.
Area of Science:
- General Surgery
- Infectious Diseases
- Gastroenterology
Background:
- Patients with Acquired Immunodeficiency Syndrome (AIDS) present unique surgical challenges, particularly with acute abdominal conditions.
- The presentation and outcomes of intra-abdominal catastrophes in this population require specific investigation.
Purpose of the Study:
- To determine the specific nature and clinical outcomes of intra-abdominal catastrophes in patients with AIDS.
- To identify common underlying pathologies and assess the prognosis for this patient group.
Main Methods:
- A prospective clinical study was conducted.
- Included were Human Immunodeficiency Virus (HIV)-positive patients presenting with an acute abdomen.
Main Results:
- Thirteen patients were analyzed, with an average age of 36 years.
- Seven patients had advanced AIDS. The ileo-caecal region was affected in 10 patients due to chronic inflammation, ulceration, and necrosis.
- Intestinal tuberculosis was diagnosed in 7 patients, and over half of the study group died during hospitalization despite optimal treatment.
Conclusions:
- The 'acute AIDS abdomen' differs significantly in nature and prognosis from previously described conditions.
- Intestinal tuberculosis should be strongly suspected as a causative factor.
- The operative mortality rate is unacceptably high, prompting investigation into alternative treatment options.
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