PERFORATION OF COLONIC DIVERTICULA ON GLU COCORTICOSTEROIDS - A COMPLICATION TO BE KNOWN

Glucocorticoids can produce acute perforation of colonic diverticula a nd peritoneal infection. We report two observations in which patients presented a peritoneal collection with no specific clinical signs. The diagnosis was considered after C-T scan or ultrasons. Residues of con trast liquid, after an earlier X-ray exploration, have made the diagno sis of diverticula easier. In one case, corticosteroids were started a s a short cure for the treatment of a myeloma. In the other case, pati ent received a long term corticosteroid therapy at low dose for an ast hmatic disease. The perforation was induced by an increased dosage. Di verticular perforations result from inhibition of synthesis of prostag landins who have the beneficial property of ''cytoprotection'' and fro m the immunosuppressive action of glucocorticoids which favour the dif fusion of the peritoneal infection.