ABDOMINAL SURGICAL EMERGENCIES IN HUMAN-I MMUNODEFICIENCY-VIRUS (HIV)INFECTED PATIENTS - A SERIES OF 34 CASES

From September 1986 to September 1994, 34 emergency laparotomies were performed in human immunodeficiency virus (HIV) seropositive patients. Patients were divided into 2 groups. Group A included 11 HIV seroposi tive patients without acquired immunodeficiency syndrome (AIDS). In th ese patients, indications for exploration included right lower quadran t pain consistent with appendicitis in 6 patients, right upper quadran t pain consistent with cholecystitis in 3 patients, small bowel obstru ction in 1 patient, and blunt abdominal trauma in 1 patient. No postop erative deaths were observed. Group B included 23 AIDS patients. Indic ations for exploration were diffuse peritonitis in 8 patients, right l ower quadrant pain consistent with appendicitis in 6 patients, right u pper quadrant pain consistent with cholecystitis in 5 patients, bowel obstruction in 2 patients, diffuse abdominal pain in 1 patient, and ma ssive rectal hemorrhage in 1 patient. The mortality rate in this group was 35% (8 out of 23 patients). Five of the 8 patients with diffuse p eritonitis died postoperatively (62%). The importance of early diagnos is and prompt surgery is emphasized to improve the prognosis in AIDS p atients, because of their poor general condition and the severity of a bdominal complications.