Skip to main content
Log in

Surgical treatment of cytomegalovirus enterocolitis in severe human immunodeficiency virus infection

Report of eight cases

  • Case Report
  • Published:
Diseases of the Colon & Rectum


PURPOSE: The aim of this study was to describe our experiences of surgical removal of inflamed bowel in cytomegalovirus enterocolitis. METHODS: Eight homosexual males with a mean age of 41 years (range, 29–59 years) and a mean CD4 count of 21×10 6/1 (1–60× 106/1)with advanced human immunodeficiency virus infection and severe cytomegalovirus enterocolitis were treated with ileocecal resection (4 patients) or right-sided hemicolectomy (4 patients). Symptoms were lower abdominal pain, severe diarrhea, fever, and weight loss, unrelieved by anticytomegalovirus therapy. Radiologic examination showed that ulcerative inflammation was limited to the right colon and terminal ileum. Microscopic examination confirmed the cytomegalovirus enterocolitis. Intermittent cytomegalovirus treatment, usually with foscarnet for 10 to 14 days every 4 to 6 weeks was given postoperatively. RESULTS: Two minor postoperative complications occurred: a lesser wound infection and a moderate bleeding from the abdominal wound edges. One patient died after three weeks because of gastrointestinal bleeding from an ulcerating Kaposi's sarcoma lesion and another patient died from unrelated causes three weeks after discharge from the hospital. The remaining 6 patients experienced complete or partial palliation of the abdominal symptoms for a mean of 14 months (range, 5–35 months) until death or the end of observation time. One patient is still alive two years after the operation. The overall mean survival was 12 months (range, 0.5–35 months). Recurrent or persistent symptoms and/or signs of cytomegalovirus enterocolitis occurred in four patients after a mean of seven months. CONCLUSION: Resection of inflamed bowel combined with postoperative anticytomegalovirus treatment leads to excellent palliation and a relatively favorable survival in AIDS patients with cytomegalovirus enterocolitis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Gerna G, Parea M, Percivalle E,et al. Human cytomegalovirus viraemia in HIV-1-seropositive patients at various clinical stages of infection. AIDS 1990;44:1027–31.

    Google Scholar 

  2. Drew WL. Cytomegalovirus infection in patients with AIDS. J Infect Dis 1988;158:449–56.

    PubMed  Google Scholar 

  3. Wexner SD, Smithy WB, Trillo C, Hopkins BS, Dailey TH. Emergency colectomy for cytomegalovirus ileocolitis in patients with the acquired immunodeficiency syndrome. Dis Colon Rectum 1988;31:755–61.

    PubMed  Google Scholar 

  4. Wilson SE, Robinson G, Williams RA,et al. Acquired immunodeficiency syndrome (AIDS), indications for abdominal surgery, pathology and outcome. Ann Surg 1989;210:428–34.

    PubMed  Google Scholar 

  5. DeRiso AJ, Kemeny M, Torres RA, Oliver JM. Multiple jejunal perforations secondary to cytomegalovirus in a patient with acquired immunodeficiency syndrome. Dig Dis Sci 1989;34:623–9.

    PubMed  Google Scholar 

  6. Tatum ET, Sun PC, Cohn DL. Cytomegalovirus vasculitis and colon perforation in a patient with the acquired immunodeficiency syndrome. Pathology 1989;21:235–8.

    PubMed  Google Scholar 

  7. Kram HB, Shoemaker WC. Intestinal perforation due to cytomegalovirus infection in patients with AIDS. Dis Colon Rectum 1990;33:1037–40.

    PubMed  Google Scholar 

  8. Wexner SD. Sexually transmitted diseases of the colon, rectum, and anus: the challenge of the nineties. Dis Colon Rectum 1990;33:1048–62.

    PubMed  Google Scholar 

  9. Burke G, Nichols L, Balogh K. Perforation of the terminal ileum with cytomegalovirus vasculitis and Kaposi's sarcoma in a patient with acquired immunodeficiency syndrome. Surgery 1987;102:540–5.

    PubMed  Google Scholar 

  10. Klatt EC, Shibata D. Cytomegalovirus infection in the acquired immunodeficiency syndrome. Arch Pathol Lab Med 1988;112:540–4.

    PubMed  Google Scholar 

  11. Francis ND, Boylston AW, Roberts AHG, Parkin JM, Pinching AJ. Cytomegalovirus infection in gastrointestinal tract of patients with HIV-1 or AIDS. J Clin Pathol 1989;42:1055–64.

    PubMed  Google Scholar 

  12. Dieterich DT, Rahmin M. Cytomegalovirus colitis in AIDS. Presentation in 44 patients and a review of the literature. J Acquir Immune Defic Syndr 1991;4(Suppl 1):29–35.

    Google Scholar 

  13. Meiselman MS, Cello JP, Margaretten W. Cytomegalovirus colitis. Gastroenterology 1985;88:171–5.

    Google Scholar 

  14. Hinnant KL, Rotterdam HZ, Bell ET, Trapper ML. Cytomegalovirus infection of the alimentary tract: a clinicopathological correlation. Am J Gastroenterol 1986;81:944–59.

    PubMed  Google Scholar 

  15. Chachona A, Dieterich D, Krasinski K,et al. 9-(1,3-dihydroxy-2-propoxymethyl)guanine (ganciclovir) in the treatment of cytomegalovirus gastrointestinal disease with the acquired immunodeficiency syndrome. Ann Intern Med 1987;107:133–7.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


About this article

Cite this article

Söderlund, C., Bratt, G.A., Engström, L. et al. Surgical treatment of cytomegalovirus enterocolitis in severe human immunodeficiency virus infection. Dis Colon Rectum 37, 63–72 (1994).

Download citation

  • Issue Date:

  • DOI:

Key words