The acute AIDS abdomen - a prospective clinical and pathological study

ABSTRACT

Objectives: Patients with AIDS who present with an acute abdomen pose a new challenge to surgeons. The purpose of this study was to determine the nature and outcome of intra-abdominal catastrophes in AIDS patients. Methods: A prospective clinical study was conducted on HIV-positive patients who presented with an acute abdomen. Results: Thirteen patients were included. Average age was 36 years. Seven patients presented with advanced AIDS. In 10 the ileo-caecal region was affected by a chronic inflammatory process resulting in ulceration and necrosis. Intestinal tuberculosis was found in 7 patients. Despite optimal treatment more than half the study group died in hospital. Conclusion: The 'acute AIDS abdomen' proved to be different in nature and prognosis than has been described previously. Intestinal tuberculosis can reasonably be suspected. Operative mortality is unacceptably high. Other treatment options are being investigated