Haller J O, Cohen H L
Department of Radiology, State University of New York Health Science Center, Downstate Medical Center, Brooklyn 11203.
AJR Am J Roentgenol. 1994 Feb;162(2):387-93. doi: 10.2214/ajr.162.2.8310932.
The gastrointestinal manifestations of AIDS in children are related to opportunistic infections, lymphoproliferative disease, and cancer. The infections that affect the gastrointestinal tract at different sites also occur in patients without AIDS. However, in children with AIDS, the infections are more severe, often relapse, and are harder to eradicate. Candidiasis is the most common infection in the esophagus, but infections caused by herpes simplex virus and cytomegalovirus also are common. Radiologic findings include ulcerations, a cobblestone appearance, and disordered motility. Gastritis and enteritis are usually caused by cytomegalovirus. Lesions produced by this virus include ulcerations caused by ischemic necrosis as a result of vasculitis. Barium studies show increased nodularity and effacement of mucosa. Other organisms (typically found in all immunocompromised patients) include Mycobacterium avium-intracellulare, Mycobacterium tuberculosis, Campylobacter, Giardia, and Cryptosporidium. Colitis and proctitis are caused by many of the same enteric pathogens. Cytomegalovirus is the most virulent, causing necrosis, perforation, and often death. Lymphoma, smooth muscle tumors, and Kaposi's sarcoma are the most common neoplasms encountered in children with AIDS.
儿童艾滋病的胃肠道表现与机会性感染、淋巴增生性疾病及癌症有关。影响胃肠道不同部位的感染在无艾滋病的患者中也会发生。然而，在患艾滋病的儿童中，这些感染更为严重，常复发且更难根除。念珠菌病是食管最常见的感染，但单纯疱疹病毒和巨细胞病毒引起的感染也很常见。放射学表现包括溃疡、鹅卵石样外观及动力紊乱。胃炎和肠炎通常由巨细胞病毒引起。该病毒产生的病变包括因血管炎导致缺血性坏死引起的溃疡。钡剂造影显示黏膜结节增多及黏膜消失。其他病原体（通常见于所有免疫功能低下的患者）包括鸟分枝杆菌复合群、结核分枝杆菌、弯曲杆菌、贾第虫和隐孢子虫。结肠炎和直肠炎由许多相同的肠道病原体引起。巨细胞病毒毒性最强，可导致坏死、穿孔，常致死亡。淋巴瘤、平滑肌瘤和卡波西肉瘤是患艾滋病儿童中最常见的肿瘤。
