Perforation of the gastrointestinal tract in patients receiving steroids for neurologic disease Journal Article
| Authors: | Fadul, C. E.; Lemann, W.; Thaler, H. T.; Posner, J. B. |
| Article Title: | Perforation of the gastrointestinal tract in patients receiving steroids for neurologic disease |
| Abstract: | Between 1980 and 1984, of 107 patients receiving 16 mg/d of dexamethasone for spinal cord compression, three (2.8%) developed gastrointestinal (GI) perforation and two (1.9%) GI bleeding; of 226 being tapered from 100 mg/d of dexamethasone, perforation occurred in six (2.7%) and GI bleeding in eight (3.5%). Of 125 patients with GI perforations treated between 1979 and 1986,41 (33%) were on steroids, 24 for neurologic disease. Median duration of steroid therapy was 24 days; 20 (91%) of the neurologic patients perforated within 30 days. The steroid group had more free peritoneal involvement (p < 0.00001), but fewer signs and symptoms of peritonitis (p < 0.000001) than the nonsteroid group. Seventeen patients were receiving steroids for cord compression; they had significantly more rectosigmoid perforations (p < 0.014) and associated constipation (p < 0.000001) than the 108 remaining patients. GI perforation is a less well-recognized complication of steroid therapy in neurologic patients than is GI bleeding though it occurs as frequently, is more difficult to diagnose, and far more serious. In steroid-treated patients, prevention of constipation might avert this serious complication, while early diagnosis will improve the outcome. © 1988 American Academy of Neurology. |
| Keywords: | adolescent; adult; child; aged; child, preschool; major clinical study; gastrointestinal hemorrhage; risk factors; dexamethasone; spinal cord compression; digestive system perforation; drug induced disease; spinal cord metastasis; gastrointestinal diseases; middle age; spinal cord neoplasms; intestinal perforation; peritonitis; human; male; female |
| Journal Title: | Neurology |
| Volume: | 38 |
| Issue: | 3 |
| ISSN: | 0028-3878 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 1988-03-01 |
| Start Page: | 348 |
| End Page: | 352 |
| Language: | English |
| DOI: | 10.1212/wnl.38.3.348 |
| PUBMED: | 3258062 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 6 August 2020 -- Source: Scopus |
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