Gastrointestinal problems in the immunocompromised host |
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Authors: | C E H Scott-Conner A J Fabrega |
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Institution: | (1) Department of Surgery, University of Iowa College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242-1086, USA, US |
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Abstract: | As the immunocompromised patient population grows, the gastrointestinal surgeon is increasingly called upon to make complex
diagnostic and therapeutic decisions. The surgeon should first identify the patient as immunocompromised and then categorize
the probable degree of immunocompromise as mild, moderate, or severe. Mildly immunocompromised patients tend to present late
and with minimal symptoms, but the disease entities are the same ones seen in the general population. Moderately and severely
immunocompromised patients may also develop the usual surgical problems, but the differential diagnosis is expanded to include
complications of the immunocompromised state or complications of the underlying problem which caused the immune compromise.
The expanded differential diagnosis includes infections with atypical organisms, opportunistic neoplasms, neutropenic enterocolitis,
complications of medications, and forms of biliary tract disease not seen in the general population. Advances in oncology,
transplantation, and the treatment of AIDS, have extended the life expectancy of these patients and increased the immunocompromised
population. Prompt appropriate operative therapy may be lifesaving when surgical complications develop.
Received: 11 April 1996/Accepted: 1 May 1996 |
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Keywords: | : Surgery — Immunosuppression — AIDS — Transplantation — Cancer — Neutropenic enterocolitis — Gastrointestinal bleeding — Gastrointestinal tuberculosis — Lymphoma |
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