title: Esophageal perforations masked by steroids.
abstract: Esophageal perforation is usually an acute, life-threatening event, and its diagnosis can be established on the basis of obvious clinical and radiographic findings. This article describes two cases whereby symptoms of esophageal perforations were masked by concomitant administration of steroids, thus causing marked delay in diagnosis and treatment. Esophageal rupture should be considered when patients receiving steroids develop unexplained fever with pleural effusion or pneumomediastinum, particularly following instrumentation or forceful retching.
authors.affiliation: Department of Medicine, Northwestern University Medical School, Chicago, Illinois 60611.
authors.forename: L M
authors.initials: LM
authors.lastname: Klygis
authors.forename: R
authors.initials: R
authors.lastname: Jutabha
authors.forename: M B
authors.initials: MB
authors.lastname: McCrohan
authors.forename: A D
authors.initials: AD
authors.lastname: Vanagunas
mesh_terms: D000328:Adult; D000368:Aged; D004935:Esophageal Diseases / Q000000981:diagnostic imaging*; D004939:Esophageal Perforation / Q000000981:diagnostic imaging*; D004947:Esophagus / Q000000981:diagnostic imaging; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011859:Radiography; D012422:Rupture, Spontaneous
chemical_list: D005938:Glucocorticoids