Perforation of the Jejunum Secondary to AIDS-Related Gastrointestinal Kaposi's Sarcoma

Abstract

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.

Predictive Clinical Factors in the Diagnosis of Gastrointestinal Kaposi's Sarcoma and Its Endoscopic Severity

“…In this study, we assessed endoscopic severity such as tumor bulk, ulceration, and multiple lesions as these may cause obstruction, hemorrhage, and perforation [14], [22]–[26]. We found, for the first time, that CD4 count (<100 cells/µL) or high HIV RNA VL (≥10,000 copies/mL) were key clinical factors to predict severe GI lesions on endoscopy.…”

“…The latter can cause serious complications such as hemorrhage, perforation, and obstruction and may require emergent treatment [14], [22]–[26]. However, there are no reports to date on the predictive clinical factors for finding severe GI-KS lesions on endoscopy.…”

Gastrointestinal Kaposi’s sarcoma: CD117 expression and the potential for misdiagnosis as gastrointestinal stromal tumour

“…Although the disease is most often asymptomatic, GI bleeding is a frequent complaint in symptomatic patients 11 . Less common clinical manifestations include intestinal perforation or obstruction, as well as appendicitis 12,13 …”

Kaposi sarcoma: A continuing conundrum

“…201,208 Classic and other KS patients may have gastrointestinal involvement such that they are first seen clinically with proteinlosing enteropathy and/or an intractable diarrhea mimicking colitis. [209][210][211] Local complications of gastrointestinal involvement such as intussusception, 212 hematemesis, 213 perforation with subsequent peritonitis, 214 or obstruction 215 may occur. Pulmonary KS may be documented by fiberoptic bronchoscopy with endobronchial biopsy analysis.…”

“…54,248 KS itself may produce clinical problems including edema from impaired lymphatic draining, difficulty ambulating, friable cutaneous nodules, secondary localized skin infection, upper airway obstruction and bilateral chylothoraces, 358 and gut disorders ranging from obstruction to appendicitis. [192][193][194][195][196][197][198][199][200][201][202][203][204][205][206][208][209][210][211][212][213][214][215]359 There is also an increased incidence of diabetes mellitus among classic KS patients. 67,112 PROGNOSIS Clinical classification of KS may be the best prognosticator, comparing localized nodular disease, locally aggressive disease, and generalized KS.…”