Document 0190
 DOCN  M94A0190
 TI    Emergent abdominal surgery in AIDS: experience in San Francisco.
 DT    9412
 AU    Whitney TM; Brunel W; Russell TR; Bossart KJ; Schecter WP; Department of
       Surgery, University of California, San Francisco.
 SO    Am J Surg. 1994 Sep;168(3):239-43. Unique Identifier : AIDSLINE
       MED/94361227
 AB    Several recent reviews have suggested that aggressive surgical
       intervention can reduce morbidity and mortality associated with
       intra-abdominal crises in AIDS patients. We reviewed our experience with
       57 AIDS patients with 63 emergent laparotomies performed at 4 hospitals
       affiliated with the University of California in San Francisco.
       Fifty-five patients (96%) were homosexual men. Thirty-nine (68%) had
       been treated for an opportunistic infection. Indications for exploration
       included right lower quadrant pain consistent with appendicitis in 24
       patients (38%), visceral perforation or obstruction in 11 (17%), right
       upper quadrant pain in 9 (14%), diffuse peritonitis in 8 (13%), and
       uncontrollable hemorrhage in 8 (13%). Perioperative mortality was 12%
       (7/57). Fifteen patients (26%) suffered major complications including
       pneumonia, sepsis, multi-organ failure, and intra-abdominal abscess.
       Forty-five of 50 survivors (90%) were receiving some type of chronic
       antimicrobial or antineoplastic chemotherapy, compared to only 2 of the
       7 patients who died (28.6%) (P < 0.001). Lack of ongoing prophylactic
       treatment for AIDS-related disease, active opportunistic infections,
       Walter Reed VI classification, and ongoing sepsis at the time of
       exploration were noted to be associated with increased morbidity and
       mortality.
 DE    Abdomen, Acute/COMPLICATIONS/MORTALITY/*SURGERY  Acquired
       Immunodeficiency Syndrome/*COMPLICATIONS  Emergencies  Human
       Laparotomy/*ADVERSE EFFECTS/MORTALITY  Male  Retrospective Studies
       JOURNAL ARTICLE

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       protected by Copyright Law (Title 17, U.S.Code).