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Abdominal pain in HIV infection
P J Thuluvath1, G M Connolly, A Forbes
1AIDS Unit, Westminster Hospital, London.
The Quarterly Journal of Medicine
|March 1, 1991
Summary
Abdominal pain in AIDS patients often stems from unique causes. Routine gastroenterological investigations effectively diagnosed most cases, with pain location predicting the cause.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Immunology
Background:
- Abdominal pain in patients with Acquired Immunodeficiency Syndrome (AIDS) presents diagnostic challenges due to differing etiologies compared to the general population.
- Optimal diagnostic guidelines for investigating abdominal pain in AIDS patients are lacking.
Purpose of the Study:
- To review the diagnostic approach and outcomes for patients with AIDS presenting with abdominal pain.
- To identify common causes of abdominal pain in this patient group and assess the utility of various investigations.
Main Methods:
- A retrospective review of 63 patients admitted to an AIDS unit with abdominal pain between January 1988 and January 1990.
- All patients underwent a structured diagnostic program utilizing routine gastroenterological investigations.
Main Results:
- The majority of abdominal pain causes were identified using standard investigations.
- Right upper quadrant pain was frequently associated with sclerosing cholangitis (17/27), often requiring endoscopic retrograde cholangio-pancreatography.
- Diffuse abdominal pain, often accompanied by diarrhea (15/21), was commonly caused by cytomegalovirus (CMV) colitis (6/21).
- Neoplasia accounted for abdominal pain in eight patients.
Conclusions:
- The predominant site of abdominal pain in AIDS patients has significant diagnostic value.
- Routine gastroenterological investigations are largely effective for diagnosing abdominal pain in AIDS.
- A suggested investigatory pathway aims to maximize diagnostic information.