A Case of Successful Three Times Abdominal Surgery in Patient with AIDS

Kiyoko Asai, Fumio Aoki, Kenji Nagasaka*, Wataru Araki*, Katsuyoshi Sugizaki and Yukiyoshi Masaki

Department of Surgery and Department of Internal Medicine*, Oume Municipal General Hospital

We report a case in which was successfully performed three times abdominal surgery in a patient with AIDS. Thirty-eight year-old male was diagnosed as AIDS caused by HIV infection in August 2003. During the course of anti-HIV therapy, he experienced severe abdominal pain, and emergency surgery led to a diagnosis of toxic megacolon due to Clostridium difficile infection. One month later, he complained of significant abdominal pain, and an X-ray showed the free air in the abdominal cavity. Surgery was performed again, and a perforated transverse colon was closed. The abdominal pain diminished, but a chest X-ray revealed a massive fluid collection in the right pleural cavity. Esophageal perforation was detected by esophagography and endoscopy. At surgery the perforation of the esophagus was closed by suturing and a muscle flap over it. No bacteria, viruses, or malignant change was observed at the site of the perforation in either the esophagus or the transverse colon. Although the CD4 lymphocyte count was low, the patient recovered from all three operations without any complications.

Key words
AIDS, perforation, intestine

Reprint requests
Kiyoko Asai Department of Surgery, Oume Municipal General Hospital
4-16-5 Higashi-Oume, Oume, 198-0042 JAPAN

Accepted
March 30, 2005

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