An Evaluation of Abdominal Manifestations by Ultrasonography in Immunodeficiency Patients

Abstract

Introduction: The major target of HIV is the immune system and the abdominal pathologies are second most commonly found in patients of AIDS after pulmonary manifestations. These abdominal manifestations are on increase may be due to immunocompromised status of these patients and due to antiretroviral therapy which has increased life expectancy in these patients. Purpose of this study is to describe abdominal findings and to evaluate clinical utility of USG in HIV patients with the use of abdominal probe, high frequency probe and Color Doppler USG. Methods: This Retrospective Analytical  study involved 60 randomly selected HIV patients attending to Local  ART Units .  Prior Consent was obtained  from Local ART Centre to see the records of the patients from there MRD .Patients of all age groups and both sex having cataract were included in the study Results: This study includes 60 HIV patients, 37 patients were male and 23 patients were female. Age group studied was 20 yrs to 65 yrs referred from ART Department . Most prevalent age group was from 40 - 49 yrs that was 23 patients, next was 30 - 39 yrs i.e. 20 patients, third in declining order was 20 - 29 yrs i.e. 12 patients and less prevalent age groups were from 50 - 59 yrs and above 60 - 70 yrs. These patients had diverse abdominal findings. Out of 60 patients 3 had no abdominal findings. Hepatomegaly was found in 33 patients, fatty hepatic changes in 14 patients and in one case there was Hepatic abscess. Lymphadenopathy was found in 28 cases. Splenomegaly was found in 20 cases and in 6 cases there were also having splenic abscesses. Ascites was found in 12 cases it was septated and non septated ascites. Cholecystitis in 4 cases. Bowel wall thickening in 5 cases in most of cases it was thickening of ileum and Ileocaecal junction thickening. Other findings were renal parenchymal disease in 2 cases, Bulky pancreas in 2 cases, cervicitis in 2 cases, one case each of cystitis and pyocele. Testicular abscess in 2 cases and gluteal abscess in one case along with other abdominal findings. Many patients had two or more pathologies. Conclusion: AIDS is multisystem disease but its demographic and clinical pattern remains same globally. USG is optimally suited for its clinical management especially in developing countries like India. Results of sonographically evaluated cases of abdominal findings are comparable to other diagnostic modalities like CT scan. The ease of availability, diagnostic accuracy of USG and its affordable cost and interventional and follow up advantages makes USG first choice of investigation for evaluation of abdominal findings. Clinico-pathological correlations can further increase its diagnostic accuracy.