title: Diffuse peritonitis in steroid-treated patients.
abstract: Patients on systemic steroid therapy are at increased risk of diffuse peritonitis, specially from gastrointestinal perforation. We performed a retrospective study of 37 patients on systemic steroid therapy who underwent surgery for diffuse peritonitis. Clinical presentation of peritonitis was usually aspecific, making the diagnosis difficult. The median interval between onset of symptoms and surgery was 3.3 days, reduced to 2.0 days between hospitalization and surgery. The mortality rate was 46% (17 of 37 patients). We emphasize aggressive diagnostic efforts and early abdominal exploration in front of any persisting abdominal pain in patients on systemic steroid therapy.
authors.affiliation: Department of General and Gastrointestinal Surgery, Hôpital de la Pitié, Paris, France. fabrice.menegaux@ps1.ap-hop-paris.fr
authors.forename: F
authors.initials: F
authors.lastname: Menegaux
authors.forename: X
authors.initials: X
authors.lastname: Chenard
authors.forename: B
authors.initials: B
authors.lastname: Wechsler
authors.forename: Z
authors.initials: Z
authors.lastname: Boutin
authors.forename: J P
authors.initials: JP
authors.lastname: Chigot
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D012189:Retrospective Studies
chemical_list: D005938:Glucocorticoids