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  Vol. 122 No. 3, March 1987 TABLE OF CONTENTS
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Peptic ulcer perforation associated with steroid use

M. T. Dayton, S. C. Kleckner and D. K. Brown

A ten-year (1974 to 1984) retrospective chart review was conducted to find all patients with peptic ulcer perforation associated with steroid treatment. During this period, 151 peptic ulcer perforations occurred, 25 (17%) associated with steroid use. Twenty patients had the diagnosis confirmed at operation, five at autopsy. The most common operative procedure was oversewing of the perforation with an omental patch (ten cases). Postoperative complications occurred in 16 patients and were multiple in 11. Underlying malignant neoplasms were the most common concurrent disease (11 patients), five patients having brain metastasis. Of 25 patients, 15 died--five preoperatively and ten postoperatively. Patients older than age 50 years had an overall mortality of 85%; those younger than age 50 years, 17%. A recurring pattern in 21 patients was perforation occurring after a major increase in steroid dose (pulse). Ulcer perforations associated with steroid use constitute a significant portion of all ulcer perforations, are lethal in most patients older than age 50 years, and are often associated with a steroid pulse before perforation.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Hypoactive Delirium as a Clinical Symptom of Intestinal Perforation
Morita et al.
Psychosomatics 1999;40:130-131.
FULL TEXT  

Corticosteroids and peptic ulceration
Ellershaw and Kelly
Palliat Med 1994;8:313-319.
ABSTRACT  





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