Burke G, Nichols L, Balogh K, Hammer S, Jensen W, Pomposelli F, Jenkins R
Surgery. 1987 Sep;102(3):540-5.
This case report documents a perforation of the terminal ileum in a 40-year-old white male homosexual with the acquired immunodeficiency syndrome. The perforation occurred at a site that had severe cytomegalovirus infection and was in close proximity to multiple nodules of Kaposi's sarcoma. The ileum showed multiple deep ulcers with large numbers of cytomegalovirus inclusions and vasculitis with infected endothelial cells, small-vessel thrombosis, focal disruption, and hemorrhage. We review the evidence that cytomegalovirus infection--and not Kaposi's sarcoma--was responsible for this perforation and, in light of the new medical therapy for such infections, should be regarded as an important cause of gastrointestinal perforation in patients with the acquired immunodeficiency syndrome.
本病例报告记录了一名40岁患有获得性免疫缺陷综合征的白人男性同性恋者回肠末端穿孔的情况。穿孔发生在一个存在严重巨细胞病毒感染且紧邻多个卡波西肉瘤结节的部位。回肠可见多个深溃疡，有大量巨细胞病毒包涵体，以及伴有受感染内皮细胞的血管炎、小血管血栓形成、局灶性破坏和出血。我们回顾了证据，表明是巨细胞病毒感染而非卡波西肉瘤导致了此次穿孔，并且鉴于针对此类感染的新医学疗法，应将其视为获得性免疫缺陷综合征患者胃肠道穿孔的一个重要原因。
