[Role of surgical visceral manifestations in the natural history of the acquired immunodeficiency syndrome in adults].

The surgical effects of AIDS in adults are rather frequent. On the basis of 74 cases, from 1985 to 1992, that we have studied clinically, by imaging procedures, biology, previous and long term follow-up, we have tried to set up the place of these effects in the natural history of the disease. The infectious complications must distinguished from tumorous ones. As to the first, we must underline the alithiasic cholecystitis, more often by cytomegalovirus, the sclerosing cholangitis and anorectal sepsis. So far as concerns tumors, note should be taken of the visceral Kaposi's tumors, and the non-hodgkins lymphomas which may given mass effect, haemorrhage or perforation. The common carcinomas shows an abnormal swiftness of growth. The complications chiefly happen at the C stage, so they are mixed up with other effects and their numerous treatments. Thereafter, the diagnosis and the treatment are difficult as well. In spite of some success in the short term on the complications themselves, the surgical procedures did not alter the general course of the disease. The advanced stage of this one leads to a high rate of mortality. Fifty-three of our patients died in a short time. We lost sight of 10 but in a critical state. The other 11 are still now in remission.