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Acute paediatrics
Bowel obstruction in an infant with AIDS
  1. J Loveland1,
  2. D M G Bowley1,
  3. I R Beavon2,
  4. G J Pitcher1
  1. 1Division of Paediatric Surgery, University of the Witwatersrand, Johannesburg Hospital, South Africa
  2. 2Department of Histopathology, Lancet Laboratories, Richmond, Johannesburg, South Africa
  1. Correspondence to:
    Dr G Pitcher, PO Box 413213, Craighall, Johannesburg 2024, Republic of South Africa;
    pitchmax{at}icon.co.za

https://doi.org/10.1136/adc.88.9.825

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    AIDS accounted for approximately one quarter of all deaths in South Africa in 2000 and has become the country’s single biggest cause of death.1 Paediatric HIV infection is now a common cause of admission to hospital and a major contributor to childhood mortality.2 A recent study reported that 60% of admissions to an academic hospital in Durban (Kwa-Zulu Natal) were infected with HIV.3 We report a case of intestinal obstruction in an infant with HIV infection, the cause of which was only diagnosed at postmortem examination.

    CASE REPORT

    A 2 month old female presented with a three day history of constipation, anorexia, and progressive abdominal distension. The child had been a full term, normal vaginal delivery to an otherwise well mother. Examination revealed a mildly dehydrated baby with a grossly distended but soft abdomen; no masses were palpable. Abdominal x ray examinationshowed multiple distended loops of small bowel, ultrasound examination was non-diagnostic, and contrast enema revealed a normal colon but was unable to adequately define the ileocaecal region. Repeat plain abdominal films 24 hours later showed features consistent with distal small bowel obstruction.

    At laparotomy, an inflammatory stricture …

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