A Case of Successful Three Times Abdominal Surgery in Patient with AIDS

We report a case in which was successfully performed three times abdominal surgery in a patient with AIDS. Thirty-eight year-old male was diagnosed as AIDS caused by HIV infection in August 2003. During the course of anti-HIV therapy, he experienced severe abdominal pain, and emergency surgery led to a diagnosis of toxic megacolon due to Clostridium difficile infection. One month later, he complained of significant abdominal pain, and an X-ray showed the free air in the abdominal cavity. Surgery was performed again, and a perforated transverse colon was closed. The abdominal pain diminished, but a chest X-ray revealed a massive fluid collec-tion in the right pleural cavity. Esophageal perforation was detected by esophagography and endoscopy. At surgery the perforation of the esophagus was closed by suturing and a muscle flap over it. No bacteria, vi-ruses, or malignant change was observed at the site of the perforation in either the esophagus or the trans-verse colon. Although the CD4 lymphocyte count was low, the patient recovered from all three operations without any complications.