The Study Of Clinical Profile Of Surgical Diseases Among Hiv Positive Patients

Abstract

INTRODUCTION :- The increasing prevalence of HIV infected patients has created the new challenges in the management of the disease. Although the scientific investigation of AIDS and HIV – related diseases has expanded, the surgical literature has remained limited with respect to the influence and outcome of surgery in HIV infected patients. There are some specific conditions, like tubercular abscess, lymphadenopathy, perianal sepsis, acute abdomen etc. associated with HIV disease syndrome which requires surgical intervention. Hence, the aim of the study was to know the clinical profile of surgical diseasesamong HIV positive patients attending the BLDE Hospital, Bijapur. MATERIALS AND METHODS :- This study was undertaken at BLDEU’S SRI B. M. PATIL MEDICAL COLLEGE, BIJAPUR, from October 2008 to May 2010.All HIV positive patients who were admitted in BLDEU’S Sri B.M.Patil Medical College/ attending surgical OPD having surgical diseases were included in this study. Details of cases recorded, including history, clinical examination and standard investigations done wherever necessary.

RESULTS :- 136 HIV infected patients with surgical diseases were included in this study. 92(68%)males and 44(32%)were females. M>F was 2:1. Most common surgical disease was Abscess formation (25%) and majority of patients had peri-anal abscess. The Ano-rectal pathology(fissure, fistula, hemorrhoids, carcinoma rectum) was seen in 30% of patients. Pulmonary complications(pleural effusion and pneumothorax), that required ICD insertion were observed in 11.7% of patients. 6 patients(4.41%) had pancreatitis and 7 patients(5.14%) had appendicitis. The incidence of lymphadenopathy, abdominal koch’s and cellulitis(3.67%) was same. X

However, the other uncommon conditions like, external iliac artery occlusion, diaphragmatic eventration, carcinoma gall bladder, malignant melanoma has been incidentally noticed in these immune-compromised patients.

CONCLUSION :-Majority of HIV infected patients suffered from abscesses and among them peri-anal abscess was the most common. The association of antiretroviral therapy and pancreatitis is known. In our study, 6 patients had pancreatitis and out of them, 5 patients had history of antiretroviral therapy. Apart from these, we came across the other uncommon surgical conditions like external iliac artery occlusion, diaphragmatic eventration, carcinoma gall bladder,malignant melanoma in HIV positive patients.