Stroganov P. Clinical features, diagnosis and treatment of acute surgical abdominal diseases in HIV-positive and HIV-negative patients with pulmonary tuberculosis

The aim was to determine the effectiveness of various methods of surgical treatment of acute abdominal disease in patients with pulmonary tuberculosis, depending on the nature of acute surgical pathology, HIV status of the patients, and on the basis of the results propose the optimal variant of surgical tactics. The advantages of acute care for patients with pulmonary tuberculosis with acute surgical abdominal pathology in anti-tuberculous hospital were indicated. It is proved that HIV-infected patients characteristically have no classic signs of perforation of a hollow organ. A method for previous-serological intraoperative clinical diagnosis of HIV was proposed. It is shown that all HIV-infected patients with pulmonary tuberculosis with peritonitis due to acute surgical diseases of the abdominal cavity was with diffuse peritonitis. Reactive phase of peritonitis was in 4 (6.78%) HIV-positive patients, a toxic phase - in 32 (54.24%) and terminal phase - in 23 (38.98%). It is proved that the limitation of the operation in patients with perforations of tuberculous ulcers of the small intestine leads to lower mortality at 31.66%. Proposed to determine the volume of surgery in patients with pulmonary tuberculosis and acute surgical abdominal diseases either patient's HIV status or the general condition of the patient and characteristics of tissues in the affected area.