Kim Seijong, Yoon Kyoung Won, Gil Eunmi, Yoo Keesang, Choi Kyung Jin, Park Chi-Min
Division of Colorectal Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Division of Critical Care, Department of Surgery, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Korea.
Ann Surg Treat Res. 2023 Feb;104(2):119-125. doi: 10.4174/astr.2023.104.2.119. Epub 2023 Jan 31.
Cytomegalovirus (CMV) infection is common in immunocompromised patients. Enterocolitis caused by CMV infection can lead to perforation and bleeding of the gastrointestinal (GI) tract, which requires emergency operation. We investigated the demographics and outcomes of patients who underwent emergency operation for CMV infection of the GI tract.
This retrospective study was conducted between January 2010 and December 2020. Patients who underwent emergency GI operation and were diagnosed with CMV infection through a pathologic examination of the surgical specimen were included. The diagnosis was confirmed using immunohistochemical staining and evaluated by experienced pathologists.
A total of 27 patients who underwent operation for CMV infection were included, 18 of whom were male with a median age of 63 years. Twenty-two patients were in an immunocompromised state. Colon (37.0%) and small bowel (37.0%) were the most infected organs. CMV antigenemia testing was performed in 19 patients; 13 of whom showed positive results. The time to diagnose CMV infection from operation and time to start ganciclovir treatment were median of 9 days. The reoperation rate was 22.2% and perforation was the most common cause of reoperation. In-hospital mortality rate was 25.9%.
CMV infection in the GI tract causes severe effects, such as hemorrhage or perforation, in immunocompromised patients. When these outcomes are observed in immunocompromised patients, suspicion of CMV infection and further evaluation for CMV detection in tissue specimens is required for proper treatment.
巨细胞病毒（CMV）感染在免疫功能低下患者中很常见。CMV感染引起的小肠结肠炎可导致胃肠道（GI）穿孔和出血，这需要紧急手术。我们调查了因胃肠道CMV感染接受紧急手术患者的人口统计学特征和手术结果。
本回顾性研究于2010年1月至2020年12月进行。纳入接受紧急胃肠道手术且通过手术标本病理检查诊断为CMV感染的患者。诊断通过免疫组织化学染色确认，并由经验丰富的病理学家评估。
共有27例因CMV感染接受手术的患者纳入研究，其中18例为男性，中位年龄63岁。22例患者处于免疫功能低下状态。结肠（37.0%）和小肠（37.0%）是最常受感染的器官。19例患者进行了CMV抗原血症检测；其中13例结果呈阳性。从手术到诊断CMV感染的时间以及开始使用更昔洛韦治疗的时间中位数为9天。再次手术率为22.2%，穿孔是再次手术最常见的原因。住院死亡率为25.9%。
胃肠道CMV感染在免疫功能低下患者中会引起严重后果，如出血或穿孔。当在免疫功能低下患者中观察到这些情况时，需要怀疑CMV感染并对组织标本进行进一步的CMV检测评估，以进行适当治疗。
