Savioz D, Lironi A, Zurbuchen P, Leissing C, Kaiser L, Morel P
Department of Digestive Surgery, University Hospital, Geneva, Switzerland.
Br J Surg. 1996 May;83(5):644-6. doi: 10.1002/bjs.1800830518.
A retrospective review was performed of the clinical features present in 17 patients who were human immunodeficiency virus (HIV) positive requiring a diagnostic or therapeutic procedure for suspected appendicitis. Patients who were acquired immune deficiency syndrome (AIDS) free (n = 11) and those with AIDS (n = 6) were compared. Ten of the 11 patients who were AIDS-free had appendicitis. The morbidity rate was 9 per cent, similar to that expected in seronegative patients, but the appendix perforation rate was 50 per cent. Only two of the six patients with AIDS had appendicitis. Three suffered from an HIV-related disease process. Computed tomography (CT) was performed in four of the six patients with AIDS, and was considered of diagnostic help in three. In patients with AIDS, the morbidity rate rose to 50 per cent. Surgical decision-making with regard to HIV-positive patients who were AIDS-free with suspected appendicitis should be similar to that for seronegative patients. For patients with AIDS, alternative diagnostic strategies, including preoperative CT, or possibly laparoscopy, should be considered.
对17例人类免疫缺陷病毒（HIV）阳性且因疑似阑尾炎而需要进行诊断或治疗性操作的患者的临床特征进行了回顾性研究。对未患获得性免疫缺陷综合征（AIDS）的患者（n = 11）和患有AIDS的患者（n = 6）进行了比较。11例未患AIDS的患者中有10例患有阑尾炎。发病率为9%，与血清阴性患者的预期发病率相似，但阑尾穿孔率为50%。6例患有AIDS的患者中只有2例患有阑尾炎。3例患有与HIV相关的疾病过程。6例患有AIDS的患者中有4例进行了计算机断层扫描（CT），其中3例认为CT有诊断帮助。在患有AIDS的患者中，发病率升至50%。对于未患AIDS但疑似阑尾炎的HIV阳性患者，手术决策应与血清阴性患者相似。对于患有AIDS的患者，应考虑采用替代诊断策略，包括术前CT或可能的腹腔镜检查。
