Abstract
The charts of 340 patients with Acquired Immunodeficiency Syndrome (AIDS), AIDS-related complex (ARC), or AIDS-prodrome (AIDS-P), treated between January 1982 and April 1986 at the Roosevelt Division of the St. Luke's-Roosevelt Hospital Center, were reviewed. The incidence of anorectal disease was 34 percent. Fifty-two patients (15 percent) presentes with anorectal complaints prior to the diagnosis of AIDS, ARC, or AIDS-P. Over 50 percent of these patients were dead within 7.4 months. Fifty-one patients (15 percent) underwent 73 anorectal surgical procedures. Twenty-two of these patients (43 percent) were dead within six months, and only six patients had satisfactory wound healing 30 days after surgery. In addition to an 88 percent rate of poor healing, there was a 16 percent rate of major complications. Identification of these high-risk groups prior to any anorectal surgery is imperative to avoid unacceptable surgical complications. Aggressive surgical intervention should be reserved only for patients who did not fall into the high-risk groups presented.
Similar content being viewed by others
References
Special Report. Epidemiologic aspects of the current outbreak of Kaposi's sarcoma and opportunistic infections. N Engl J Med 1982;306:248–52.
Marwick C. Task force to coordinate study, testing of AIDS therapies. JAMA 1986;255:1233–42.
CDC Update. Acquired immunodeficiency syndrome: United States. MMWR 1986;35:17–21.
Blackman E, Vimadalal S, Nash G. Significance of gastrointestinal cytomegalovirus infection in homosexual males. Am J Gastroenterol 1984;79:935–40.
McMillan A, Smith IW. Painful anal ulceration in homosexual men. Br J Surg 1984;71:215–6.
McMillan A, Gilmour HM, Slatford K, McNeillage GJ. Proctitis in hornosexual men: a diagnostic problem. Br J Vener Dis 1983;59:260–4.
Mindel A. Lymphogranuloma venereum of the rectum in a homosexual man: case report. Br J Vener Dis 1983;59:196–7.
Goodell SE, Quinn TC, Mkrtichian E, Schuffler MD, Holmes KK, Corey I. Herpes simplex virus proctitis in homosexual men: clinical sigmoidoscopic, and histopathological features. N Engl J Med 1983;308:868–71.
Bolan RK, Sands M, Schachter J, Miner RC, Drew WL. Lymphogranucoma venereum and acute ulcerative proctitis. Am J Med 1982;72:703–6.
Fluker JL, Deherogoda P, Platt DJ, Gerken A. Rectal gonorrhoea in male homosexuals: presentation and therapy. Br J Vener Dis 1980;56:397–9.
Levine JS, Smith PD, Brugge WR. Chronic proctitis in male homosexuals due to lymphogranuloma venereum. Gastroenterology 1980;79:563–5.
Goldmeier D. Proctitis and herpes simplex virus in homosexual men. Br J Vener Dis 1980;56:111–4.
Faris MR, Perry JJ, Westermeier TG, Redmond J III. Rectal syphilis mimicking histiocytic lymphoma. Am J Clin Pathol 1983;80:719–21.
Weller IV. The gay bowel. Gut 1985;26:869–75.
Daul CB, deShazo RD. Acquired immune deficiency syndrome (AIDS: medical challenge of the 80s. Postgrad Med 1984;76:167–79.
Judson FN. Sexually transmitted viral hepatitis and enteric pathogens. Urol Clin North Am 1984;11:177–85.
Quinn TC, Stamm WE, Goodell SE, et al. The polymicrobial origin of intestinal infections in homosexual men. N Engl J Med 1983;309:576–82.
Baker RW, Peppercorn MA. Gastrointestinal ailments of homosexual men. Medicine 1982;61:390–405.
Heller M. The gay bowel syndrome: a common problem of homosexual patients in the emergency department. Ann Emerg Med 1980;9:487–93.
Quinn TC, Corey L, Chaffee RG, Schuffler MD, Holmes KK. Campylobacter proctitis in a homosexual man. Ann Intern Med 1980;93:458–9.
Rompalo AM, Stamm WE. Anorectal and enteric infections in homosexual men. West J Med 1985;142:647–52.
Quinn TC. Gastrointestinal manifestations of AIDS. Practical. Gastroenterology 1985;9:23–34.
Bianco J, Pratt-Bianco L. Kaposi's sarcoma of the rectum: a case report. Mt Sinai J Med 1983;50:278–80.
Ebbesen P, Biggar RJ, Melbye M, eds. AIDS: a basic guide for clinicians. Philadelphia: WB Saunders, 1984.
Coonley CJ, Straus DJ, Filippa D, Watson R. Hodgkin's disease presenting with rectal symptoms in a homosexual male: a case report and review of the literature. Cancer Invest 1984;2:279–84.
Read EJ, Orenstein JM, Chorba TL, et al. Listeria monocytogenes sepsis and small cell carcinoma of the rectum: an unusual presentation of the acquired immunodeficiency syndrome. Am J Clin Pathol 1985;83:385–9.
Croxson T, Chabon AB, Rorat E, Barash IM. Intraepithelial carcinoma of the anus in homosexual men. Dis Colon Rectum 1984;27:325–30.
Siegal FP, Lopez C, Hammer GS, et al. Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions. N Engl J Med 1981;305:1439–44.
DeVita VT, Hellman S, Rosenberg SA. AIDS: etiology, diagnosis, treatment, and prevention. Philadelphia: JB Lippincott, 1985:3.
Goldberg SM, Gordon PH, Nivatvongs S, eds. Essentials of anorectal surgery. Philadelphia: JB Lippincott, 1980:81–2, 97–8, 119–21.
Author information
Authors and Affiliations
Additional information
This paper received the New York Society of Colon and Rectal Surgeons A. W. Martin Marino, Sr., M.D., Award at the meeting of the American Society of Colon and Rectal Surgeons, Houston, Texas, May 11 to 15, 1986.
About this article
Cite this article
Wexner, S.D., Smithy, W.B., Milsom, J.W. et al. The surgical management of anorectal diseases in AIDS and pre-AIDS patients. Dis Colon Rectum 29, 719–723 (1986). https://doi.org/10.1007/BF02555318
Issue Date:
DOI: https://doi.org/10.1007/BF02555318