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Emergency abdominal operations in the patient with acquired immunodeficiency syndrome
L S Bizer1, R Pettorino, A Ashikari
1Department of Surgery, Montefiore Medical Center, Bronx, NY.
Background:
We have previously shown high morbidity and mortality rates in patients with acquired immunodeficiency syndrome (AIDS) who require emergency abdominal operations. In a larger series of patients, we have investigated the reasons for these findings and have hypothesized that they are primarily the result of starvation and decreased resistance to infection.
Study Design:
A retrospective review of the clinical records of patients at Montefiore Medical Center and its two associated municipal hospitals was done during a six year period.
Results:
Postoperative morbidity and mortality rates of 50 and 38 percent, respectively, were documented and seem to be related to immunosuppression and the malnourished condition of these patients.
Conclusions:
Patients who meet the criteria for the diagnosis of AIDS have increased morbidity and mortality rates after emergency abdominal operations. This, however, should not exclude these patients from operation when it is indicated because many will survive and benefit from the operative procedure. Attention to nutritional support and the early diagnosis and treatment of associated infectious complications may result in decreased morbidity and mortality rates subsequent to the emergency abdominal operations.