Obstructive Gastric Pseudotumor Caused by Cytomegalovirus in an AIDS Patient: A Case Report and Review of Surgical Treatment
Challenging differential diagnosis, Educational Purpose (only if useful for a systematic review or synthesis), Rare co-existance of disease or pathology
Yuri Longatto Boteon, Iuri Pedreira Filardi Alves, Amanda Pinter Carvalheiro da Silva, Valdir Tercioti Junior, João de Souza Coelho Neto, Luiz Roberto Lopes, Marcelo de Carvalho Ramos, Nelson Adami Andreollo
Department of Surgery, Faculty of Medical Sciences, State University of Campinas (Unicamp) and in the Diagnostic Center for Digestive Diseases (Gastrocentro), Unicamp, Campinas, Sao Paulo, Brazil
Am J Case Rep 2015; 16:536-541
Cytomegalovirus (CMV) is a common opportunistic pathogen in patients with HIV. It is also a major cause of gastrointestinal ulcers in patients with acquired immunodeficiency syndrome (AIDS). CMV pseudotumor in the stomach is a rare cause of digestive tract obstruction.
CASE REPORT: In this study we report a male patient infected with HIV in 2002. In 2014 he evolved C3 stage AIDS with pre-pyloric gastric ulcer which provoked deformity and pseudotumoral aspect of the gastric outlet. Endoscopic biopsy confirmed CMV infection. He underwent Roux-en-Y gastroenteroanastomosis with good recovery.
CONCLUSIONS: CMV infection should be considered as an agent in gastric lesions in HIV-infected patients. Roux-en-Y gastroenteroanastomosis is a surgical option for this group of patients, allowing improvements in quality of life and decreasing risks of perioperative complications.
Keywords: Adult, AIDS-Related Opportunistic Infections - therapy, Cytomegalovirus, Cytomegalovirus Infections - therapy, Gastric Outlet Obstruction - virology