Injection treatment of hemorrhoids in patients with acquired immunodeficiency syndrome.
OBJECTIVE
Patients with acquired immunodeficiency syndrome are often in poor general physical condition. Diarrhea and bleeding hemorrhoids frequently contribute to the morbidity, and patients with such problems cause an increasing load on many outpatient clinics.


METHODS
Twenty-two patients (17 males) with acquired immunodeficiency syndrome had injection treatment for bleeding second-degree to fourth-degree hemorrhoids according to standard outpatient clinic routines. Mean follow-up was 24 months.


RESULTS
No complications were recorded. The treatment was successful in all patients, and no hemorrhoidectomy was necessary. Nineteen patients improved after their first injection, whereas 3 patients required two to six weeks repeated treatments to improve. Four subjects with the longer follow-up (4 years) showed an improvement lasting 12 to 18 months and then required one to two treatments per year to stop recurrent bleeding.


CONCLUSIONS
Because of their poor general condition and poor wound healing, a conservative approach is preferable to avoid a formal hemorrhoidectomy in patients with acquired immunodeficiency syndrome. Sclerotherapy seems to be an attractive alternative.
Scaglia
M
M
Divisione di Chirurgia Generale, Ospedale S. Luigi Gonzaga, Orbassano, Torino, Italy.
Delaini
G G
GG
Destefano
I
I
Hultén
L
L
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000628:therapy*; D019053:HIV Enteropathy / Q000150:complications / Q000628:therapy*; D006484:Hemorrhoids / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D011351:Proctoscopy; D012008:Recurrence; D019233:Retreatment; D015911:Sclerotherapy