Laparotomy in patients infected with human immunodeficiency virus: indications and outcome.

Four distinct disease processes account for the majority of surgically correctable intra-abdominal pathologies associated with human immunodeficiency virus (HIV) infection: cytomegalovirus infection, Kaposi's sarcoma, non-Hodgkin's lymphoma and mycobacterial infection. Affected patients may also develop acute cholecystitis and appendicitis with significant frequency. Thorough investigation, when possible, will obviate the need for laparotomy in most HIV-infected patients with abdominal symptoms and signs. In those who require surgical intervention, the outcome varies greatly according to the nature of the diagnosis.