A Case of Small Bowel Obstruction due to Mycobacterium Avium Intracellulare Associated with the Acquired Immunodeficiency Syndrome

Soichiro Murata, Naohide Isaka, Keiichi Yamada, Satoshi Inagawa, Shigeru Atake, Katsuhisa Tsuji, Akio Ishikawa and Yukinori Inadome*

Department of Gastroenterological Surgery and Department of Pathology*,
Tsukuba Medical Center Hospital

A 48-year-old man with AIDS complicated by small bowel obstruction due to Mycobacterium avium intracellulare (MAI) was successfully treated in emergency surgery. Here, we report on the case. The man was diagnosed with AIDS based on a history, with a history of pneumocystis carinii in 1996 and was treated with antiretroviral drugs. He then came down with cytomegaloviral retinitis and disseminated MAI with cervical lymphadenopathy.
When admitted in 2000, for left lower abdominal pain, he was found on physical examination to have tenderness localized to the left lower abdominal quadrant. Based on a diagnosis of small bowel obstruction, he was treated conservatively, but his symptoms of peritonitis worsened 3 days after admission, necessitating emergency laparotomy. Marked lymphadenopathy was found between the first and second jejunal arteries and an inflammatory adhesion had formed in the ligament toward the transverse colon, obstructing the small bowel. This was relieved by lysis of the adhesions. The postoperative course was uneventful and he discharged with good oral intake, but died 123 days after surgery due to progressive AIDS.

Key words
HIV, small bowel obstruction, Mycobacterium avium intracellulare

Reprint requests
Soichiro Murata University of Tsukuba Hospital Surgery 2-1-1 Amakubo, Tsukuba, 305-8576 JAPAN

Accepted
October 30, 2002

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