Gastrointestinal problems in the immunocompromised host. A review for surgeons

Area of Science:

• Gastrointestinal Surgery
• Immunology
• Oncology

Background:

• The immunocompromised patient population is expanding due to advances in oncology, transplantation, and AIDS treatment.
• Gastrointestinal surgeons increasingly manage complex cases in these patients.
• Understanding the degree of immune compromise is crucial for diagnosis and treatment.

Purpose of the Study:

• To outline diagnostic and therapeutic strategies for gastrointestinal surgeons managing immunocompromised patients.
• To highlight the expanded differential diagnosis in moderately and severely immunocompromised individuals.
• To emphasize the importance of prompt surgical intervention.

Main Methods:

• Clinical assessment to categorize patients as mildly, moderately, or severely immunocompromised.
• Review of common and atypical surgical presentations in immunocompromised hosts.
• Consideration of complications related to the immunocompromised state itself.

Main Results:

• Mildly immunocompromised patients present with common surgical diseases, often with delayed symptoms.
• Moderately and severely immunocompromised patients face an expanded differential diagnosis.
• This includes opportunistic infections, neoplasms, neutropenic enterocolitis, medication side effects, and unusual biliary tract diseases.

Conclusions:

• Accurate assessment of immune status is paramount for effective surgical management.
• The differential diagnosis for surgical complications in immunocompromised patients is significantly broader.
• Timely and appropriate surgical intervention can be life-saving.