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Query: UMLS:C0000727 (acute abdomen)
 3,084 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cytomegalovirus disease is an opportunistic infection that is seen in patients with inmunodeficiencies. The group most commonly affected are AIDS and transplanted patients. Only a few cases of cytomegalovirus disease in non-immunocompromised patients have been reported. In localized disease, the gastrointestinal tract is the most frequently affected. We report two cases of acute abdomen caused by cytomegalovirus enteritis and colitis (histopathological diagnosis) without any underlying immune disorder. The role that the cytomegalovirus infection might play in the development of the clinical manifestations in these two cases is discussed. Without an established immunodeficiency we must be careful to attribute to cytomegalovirus infection the direct responsibility of the lesions. In the reported cases, the existence of intestinal ischemia is more than just a clinical hypothesis and pathological examination is inconclusive. The absence of an immunocompromised state, the presentation as an acute abdomen and the clinical course forwards intestinal occlusion in the first case are not characteristic of cytomegalovirus enteritis and colitis. We conclude that the two reported cases are in fact an ischemic enteritis upon which cytomegalovirus enteritis and colitis was superimposed, an association that has not been reported before.
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PMID:[Cytomegalovirus enteritis and colitis in nonimmunodepressed patients, a primary disease or superinfection?]. 798 12

This article reports a case of cytomegalovirus (CMV) ileitis with perforation in a woman with transfusion-acquired human immunodeficiency virus (HIV) infection. The clinical problem of small bowel perforation due to CMV disease in association with HIV infection is emphasized. Typically, a patient with a history of chronic diarrhea, fever, and abdominal pain develops the superimposed picture of an acute abdomen and has pneumoperitonium on radiograph. The prognosis is poor.
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PMID:Ileal perforation due to cytomegalovirus infection. 816 91

A case of abdominal mycobacterial infection mimicking acute appendicitis in a human immunodeficiency virus (HIV) infected patient is reported. The case illustrates the unusual aetiology of an acute abdomen in this population and the report reviews the aetiology of surgical abdominal pain in HIV infection and discusses the management of abdominal mycobacterial infections.
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PMID:Abdominal mycobacterial infection mimicking acute appendicitis in an AIDS patient. 831 83

Intestinal perforation is an extremely uncommon complication of Mycobacterium tuberculosis (MTB) infection. We describe two cases of multiple intestinal perforations secondary to MTB in individuals infected with the human immunodeficiency virus (HIV) presenting at the Los Angeles County-University of Southern California Medical Center over a 2-month period. For each case, this was the first presentation of AIDS. One of the two patients had concurrent pulmonary involvement. One patient died, and the other responded to therapy and was discharged in stable condition. The most striking finding in both cases was the extremely large number of acid-fast bacteria seen transmurally on the pathological specimens. This might be related to impaired T-cell function. The resurgence of MTB infection in North America, in the presence of the AIDS epidemic, may result in an increasing frequency of unusual presentations, such as intestinal perforation. Intestinal perforation due to MTB should be considered in HIV-infected patients presenting with an acute abdomen.
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PMID:Intestinal perforation due to Mycobacterium tuberculosis in HIV-infected individuals: report of two cases. 847 Jun 47

Tuberculosis (TB) in human immunodeficiency virus (HIV) immunosuppressed patients is characterized by extra-pulmonary disease in as many of 70% of them. If intestinal or lymph node involvement occurs, the differential diagnosis between an acute abdomen and other non surgical conditions may be a challenging problem. The authors analyzed eight double infected patients (TB and acquired immunodeficiency syndrome AIDS), who were admitted to the University Hospital (HUCFF) of the Federal University of Rio de Janeiro. This association should be considered when abdominal pain, anemia, fever, weight loss and abdominal lymph node enlargement are present. Bacteriology of body fluids, abdominal ultrasound (US) and computed tomography scans (CT) combined with guided needle aspiration biopsies, barium examination, colonoscopy and laparoscopy, can not only elucidate the diagnosis but also be helpful in assessing an appropriate management. Thus a systematic evaluation often yields an etiology and a correct therapeutic indication reducing the high mortality rate.
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PMID:Intra-abdominal tuberculosis in acquired immunodeficiency syndrome. Diagnosis and management. 853 Feb 32

Intestinal perforation in human immunodeficiency virus-positive patients due solely to Kaposi's sarcoma (KS) has rarely been described. A homosexual man with acquired immunodeficiency syndrome-related KS who presented with an acute abdomen is presented. He was found to have a jejunal perforation through a small KS lesion. There were no infectious organisms identified at the site of perforation.
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PMID:Perforation of the jejunum secondary to AIDS-related gastrointestinal Kaposi's sarcoma. 911 97

A case of hepatobiliary dysfunction as the initial manifestation of disseminated cryptococcosis is described. The patient was admitted with symptoms of hepatitis with cholestatic jaundice. Antibody tests for hepatitis B and C and human immunodeficiency virus were negative. The patient continued to deteriorate clinically. Eventually, the patient succumbed to hepatic failure. Autopsy disclosed systemic cryptococcosis that caused extensive necrosis of the liver. In review of the literature, only nine cases of cryptococcal infection presenting as hepatitis, cholangitis, and cholecystitis as initial manifestation were reported. Four of these patients had been subjected to exploratory laparotomy for clinical suspicion of acute abdomen. One patient developed cirrhosis as a result of cryptococcal hepatitis. Two patients succumbed to hepatic failure. Cryptococcosis is known to occur commonly in immunocompromised patients, yet only two reported cases presenting as hepatitis were associated with immunocompromised status.
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PMID:Hepatobiliary dysfunction as the initial manifestation of disseminated cryptococcosis. 1019 23

As the prevalence of human immunodeficiency virus (HIV) infection continues to rise the clinician is encountered with a diagnostic challenge. Nonsurgical diseases such as acute colitis or enteritis can appear similar to such true surgical emergencies as abscess, perforation, or mesenteric ischemia. We report a case of fulminant hepatic failure associated with didanosine and masquerading as a surgical abdomen and compare the clinical, biologic, histologic, and ultrastructural findings with reports described previously. This entity should be kept in mind when evaluating the acute abdomen in the HIV-positive patient.
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PMID:Antiretroviral-induced hepatic steatosis and lactic acidosis: case report and review of the literature. 1145 Jul 88

We report a case of phlegmonous gastritis associated with Kaposi sarcoma in a 37-year-old, human immunodeficiency virus (HIV)-positive man who presented with an acute abdomen. Computed tomographic scan revealed free fluid in the abdominal cavity and a thickened gastric wall. A partial gastrectomy was performed. The resected portion of stomach had a hemorrhagic, necrotic thickened wall and showed extensive, acute suppurative inflammation, especially in the submucosa, with focal transmural involvement. Beneath an area of healing ulceration, a focus of Kaposi sarcoma was present. Group A beta-hemolytic streptococcus was grown from peritoneal fluid, and treatment with numerous antibiotics was initiated. After a difficult postoperative course that responded to 8 weeks of antibiotic therapy, the patient was medically stable and discharged from the hospital on antiretroviral therapy for HIV. Phlegmonous gastritis is a rare and rapidly progressive bacterial infection of the gastric wall. Kaposi sarcoma is one of the most common malignancies in HIV-positive patients, and gastric involvement is relatively common in those patients with systemic Kaposi sarcoma. To our knowledge, this is the first reported case of phlegmonous gastritis associated with Kaposi sarcoma, and it represents a rare survival following surgical and antibiotic therapy.
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PMID:Phlegmonous gastritis associated with Kaposi sarcoma: a case report and review of the literature. 1521 17

Recent advances in transplantation, oncology and AIDS therapy have greatly increased life expectancies of patients diagnosed with malignancy, auto-immune disorders and organ failure. However, as this immune compromised population grows, complications of such therapies have become a major source of morbidity and mortality. Classical clinical and laboratory evidence of intra-abdominal pathology may be absent in the immune compromised host. Consequently, the radiologist is increasingly called upon to diagnose acute intra-abdominal complications associated with immunodeficiency. This review explores the aetiology of the acute abdomen in the immune compromised host. The typical radiological appearances of the commonest conditions are illustrated. The challenges and limitations in the radiological diagnosis of these conditions are discussed.
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PMID:The acute abdomen in the immune compromised host. 1844 55


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