The surgical management of anorectal diseases in AIDS and pre-AIDS patients

Wexner, Steven D.; Smithy, William B.; Milsom, Jeffrey W.; Dailey, Thomas H.

doi:10.1007/bf02555318

Cited by 137 publications

(46 citation statements)

References 18 publications

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“…Anorectal pathologies are common in HIV+ persons, and about one-third of infected individuals are known to develop anorectal problems in their life time [8,9].…”

Section: Discussionmentioning

confidence: 99%

Clinical Profile of Surgical Diseases with Emergence of New Problems in HIV+ Individuals

et al. 2016

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North Karnataka is one of the regions with the high prevalence of HIV+ individuals. Bijapur is a district in North Karnataka with high prevalence as per fact sheets of NACO of March 2012. Better awareness, access to health care, and antiretroviral therapy have improved survival and increase in number of people living with HIV/ AIDS (PLHA). Improved survival has increased their attendance to hospitals with variety of surgical problems, some known and some less known. The percentage of HIV+ individuals was 1.64 % among all admissions. Of these individuals, 13.65 % (272) had surgical problems. Abscesses were the commonest. Abscesses at uncommon sites also were encountered. Anorectal pathologies, tuberculosis, lymphadenopathy, appendicitis, etc. commonly seen in HIV+ individuals were seen. Drug-induced pancreatitis due to anti retroviral therapy was one of the common problems encountered. Uncommon conditions like ureteric calculi, external iliac artery thrombosis, diaphragmatic eventration, and few more were observed. Even though literature on AIDS/HIV is abundant, there is less information on surgical conditions encountered more so from this part of the subcontinent. Hence, it was decided to report the profile of the conditions encountered.

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“…Anorectal pathologies are common in HIV+ persons, and about one-third of infected individuals are known to develop anorectal problems in their life time [8,9].…”

Section: Discussionmentioning

confidence: 99%

Clinical Profile of Surgical Diseases with Emergence of New Problems in HIV+ Individuals

et al. 2016

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“…One-third of patients with anorectal wounds required more than 6 months to heal, 12) although adequate wound healing was seen in 88% to 94% of HIV-positive patients. 2) Wound healing was uneventful after excision of a malignant melanoma of the scalp in a patient with AIDS.…”

Section: Discussionmentioning

confidence: 99%

Aneurysmal Subarachnoid Hemorrhage in a Patient With Human Immunodeficiency Virus Type 1 Infection-Case Report-

Miyamoto

Hara

Tabei

et al. 2006

Neurol. Med. Chir.(Tokyo)

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A 54-year-old human immunodeficiency virus type 1 (HIV-1)-infected homosexual Japanese male was found to have collapsed in his bathroom and was brought to our facility with diminished level of consciousness. Computed tomography showed subarachnoid hemorrhage (SAH). He was severely dehydrated with unstable general status that deterred us from performing emergent surgery. Cerebral angiography performed on the 18th hospital day revealed bilateral distal anterior cerebral artery aneurysms. Clipping of these aneurysms was performed on the 30th hospital day and no postoperative complications were experienced. The scalp wound showed no delayed healing, whereas the tracheostomy wound showed repeated wound dehiscence and delayed healing. Postoperative highly active antiretroviral therapy with antibiotic treatment gradually improved his general and immunological conditions. The patient was finally discharged as independent with mild muscle weakness in the bilateral lower extremities. HIV-1 infection should not be the guiding factor in the decision to aggressively treat concomitant aneurysmal disease. Clipping of cerebral aneurysms with full craniotomy or endovascular obliteration should be considered even in HIV-1-infected patients with SAH.

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“…We therefore chose management for AIDS in order to improve the patient's CD4 lymphocyte count and reduce the HIV-1 RNA level; namely, the administration of AZT, NFV and 3TC prior to the operation for gastric cancer. It has been controversial whether surgeons should operate on patients with HIV infection in the late stage, because of delayed wound healing [9,10]. It has been described previously that anorectal surgery in patients with HIV infection and AIDS, particularly those who are severely immunodeficient according to the Centers for Disease Control (CDC) category B and C, is associated with a high incidence of delayed wound healing [9,11,12].…”

Section: Discussionmentioning

confidence: 99%

“…It has been controversial whether surgeons should operate on patients with HIV infection in the late stage, because of delayed wound healing [9,10]. It has been described previously that anorectal surgery in patients with HIV infection and AIDS, particularly those who are severely immunodeficient according to the Centers for Disease Control (CDC) category B and C, is associated with a high incidence of delayed wound healing [9,11,12]. In most of the reported AIDS patients with gastric carcinoma, the patients had a poor prognosis as a result of their far-advanced neoplastic disease.…”

Section: Discussionmentioning

confidence: 99%