[Ileal loop perforation caused by tuberculosis in patients with the acquired immunodeficiency syndrome]

This clinical and surgical study was performed in a Public Government Hospital with the purpose of investigating the etiology and treatment of acute perforative abdomen in AIDS patients, particularly in the case of intestinal tuberculosis. The authors describe the cases of two young male AIDS patients with acute abdomen in which surgery revealed intestinal ileal perforation due to tuberculosis. One of the patients did not survive due to his poor post-operative condition. The other case had a better evolution and was submitted to outpatient care. The immediate surgery with occlusion of the perforation and biopsy of the lesion permitted to arrive at the etiology and contributed to the good evolution of the second patient.

Literature indicates cytomegalovirus as the main cause of intestinal perforation in AIDS patients. In this study, etiology was tuberculous and this is probably an important cause of acute perforative abdomen in our AIDS patients due to the general prevalence of tuberculosis in AIDS patients in Brazil and in other developing countries.