Abdominal Pain in Patients with Acquired Immune Deficiency Syndrome

Barone, James E.; Gingold, Bruce S.; Arvanitis, Michalis; Nealon, Thomas F.

doi:10.1097/00000658-198612000-00001

Cited by 67 publications

(11 citation statements)

References 5 publications

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“…Anorectal disease is the most frequent reason for surgical referral in HIV and AIDS patients and this reflects the large number of studies already published, meanwhile the frequency of laparotomy remains low at between 2 and 4% [13, 14, 15]. The healing of anorectal wounds, however, is not straightforward and may not reflect the overall healing of wounds in these patients.…”

Section: Introductionmentioning

confidence: 99%

Increased Risk of Wound Complications and Poor Healing following Laparotomy in HIV-Seropositive and AIDS Patients

Davis

Corless²,

Gazzard³

et al. 1999

Dig Surg

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The number of individuals in the UK who are HIV seropositive is increasing as is their presentation with abdominal complications. Poor wound healing following anorectal surgery in HIV-positive patients has been well reported. This study reviews the incidence of wound complications following laparotomy. The hospital records of all HIV-positive patients who underwent laparotomy at a London teaching hospital over a 10-year period were reviewed and compared to an equal number of matched non-HIV patients. Between April 1986 and April 1996, 64 laparotomies were carried out on 53 patients. There was a significantly greater incidence of wound complications (χ² = 12.75, 1 d.f., p = 0.0003) and wound breakdown (χ² = 10.45, 1 d.f., p = 0.012) in the HIV group following laparotomy than in the non-HIV control group.

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Section: Introductionmentioning

confidence: 99%

Increased Risk of Wound Complications and Poor Healing following Laparotomy in HIV-Seropositive and AIDS Patients

Davis

Corless²,

Gazzard³

et al. 1999

Dig Surg

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“…The incidence of abdominal surgery in patients with AIDS was reported to be 2.1%-4.2% in early reports from the United States [1,7,8]. Conditions necessitating abdominal surgery were cholecystitis, splenic disorders, acute appendicitis, and peritonitis.…”

Section: Discussionmentioning

confidence: 99%

Gastrectomy for a patient with early gastric cancer and human immunodeficiency virus (HIV) infection

et al. 2001

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thologists, with this condition and operation, we present the clinical, surgical, and pathological data of our patient; we also review the cases in the literature. Case reportA 49-year-old man underwent gastric fiberscopy because of a positive result on a fecal occult blood test. He had a 6-year history of HIV infection, which had been controlled with anti-HIV drugs, including indinavir sulfate ethanolate, lamividine, and sanilvudine. On gastric fiberscopy, there was an irregularly shaped, superficially depressed, IIc-type lesion on the anterior wall of the gastric antrum. Histologic examination of the biopsy specimen showed that the lesion was a well differentiated tubular adenocarcinoma of the stomach. Physical examination revealed no palpable lymph nodes, and total colonoscopy disclosed a small adenomatous polyp of the sigmoid colon. Blood data were as follows: red blood cells, 358 ϫ 10 4 /mm 3 , white blood cells, 6000/mm 3 ; lymphocytes, 27.5%; CD 4ϩ cell count, 530/mm 3 ; CD 4ϩ , 31.2%; CD 8ϩ , 42.2%; CD 4ϩ /CD 8ϩ , 0.74; platelets, 16.9 ϫ 10 4 /mm 3 ; total protein, 8.10 g/dl; albumin, 4.58 g/dl; c-reactive protein (CRP), 0.47 mg/dl; and carcinoembryonic antigen (CEA), 1.3 ng/ml. With a diagnosis of early gastric cancer associated with HIV infection, we carried out Billroth I gastrectomy, on October 16, 2000.At operation, we abided strictly by standard precautions for patients with HIV infection. All surgeons and the assistant nurse wore surgical caps, masks, goggles, gowns, two pairs of gloves, and stockings (Fig. 1). Surgical instruments were handed from assistant nurse to operator, and the knife, needles, and blood-contaminated gauzes were placed in a tray by the operator and emptied into a needle-stick prevention box (Sharps Container XX-ST08B; Terumo, Tokyo, Japan) by the third assistant (Fig. 2). With the patient under general Abstract Gastric cancer associated with human immunodeficiency virus (HIV) infection is rare, and mostly results in a poor outcome. We report a patient with HIV infection and early gastric cancer successufully treated by gastrectomy. A 49-year-old man with a 6-year history of HIV infection underwent gastric fiberscopy, and a IIc-type depressed lesion was detected in the gastric antrum. With a diagnosis of early gastric cancer, we abided strictly by standard precautions for patients with HIV infection and carried out Billroth I gastrectomy. Histologic examination revealed that the lesion (which measured 0.9 ϫ ϫ ϫ ϫ ϫ 0.4 cm in size), was well differentiated tubular adenocarcinoma confined to the mucosa. A review of the literature disclosed that this is the first reported case of early gastric cancer associated with HIV infection.

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“…Nach ersten pessimistischen Einschätzungen aus der Anfangszeit der HIV-Pandemie [7,12,25,42,45,49] besteht auf Grund der nunmehr vorliegenden Befunde aus der jüngeren Literatur heute kein Anlass mehr, HIV-infizierten Patienten elektive oder notfallchirurgische Eingriffe zu verweigern beziehungsweise deren Durchführung unbillig zu verzögern [19,26,60]. Es gibt im Gegenteil Hinweise darauf, dass sich im Laufe der letzten Jahre die Operationsergebnisse bei diesen Personen deutlich gebessert haben [31, 60, eigene Auswertung].…”

Section: Schlussfolgerungenunclassified

Spektrum und Ergebnisse operativer Eingriffe bei HIV-infizierten Patienten: Spectrum and results of operative interventions in HIV-infected patients

Becker¹,

Erckenbrecht²

2001

Der Chirurg

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Owing to their number, multimorbidity, and prolonged survival following improved antiretroviral therapy, HIV-infected subjects represent an important subgroup of the patients requiring surgical treatment. The spectrum of operative interventions performed in these people comprises both characteristic diagnostic, palliative, and therapeutic measures and all the same surgical indications as in an age-matched non-HIV-infected patient population. Published data concerning the results of operative interventions in these patients are rather scarce. The surgical success rate is 68-90% for elective therapeutic measures. In 21-94% of HIV-infected patients intraoperative findings of a HIV-associated opportunistic disease are reported. Depending on patient selection and the kind of operation performed, the perioperative morbidity of these subjects was 9-87% (median 33.5%), while postoperative mortality ranged from 0 to 71% (median 8%). Particular determining factors of perioperative morbidity and mortality are the degree of individual immunosuppression and the urgency of surgical intervention. In summary, operation-associated morbidity and mortality of HIV-infected patients appear not to be significantly increased compared to non-HIV-infected patients in similar preoperative health condition. The present analysis reflects a marked improvement of operative results in HIV-infected patients during the past 20 years.

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Abdominal Pain in Patients with Acquired Immune Deficiency Syndrome

Cited by 67 publications

References 5 publications

Increased Risk of Wound Complications and Poor Healing following Laparotomy in HIV-Seropositive and AIDS Patients

Increased Risk of Wound Complications and Poor Healing following Laparotomy in HIV-Seropositive and AIDS Patients

Gastrectomy for a patient with early gastric cancer and human immunodeficiency virus (HIV) infection

Spektrum und Ergebnisse operativer Eingriffe bei HIV-infizierten Patienten: Spectrum and results of operative interventions in HIV-infected patients

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