LOWER GASTROINTESTINAL-TRACT PERFORATION IN PRETERM INFANTS TREATED WITH DEXAMETHASONE FOR BRONCHOPULMONARY DYSPLASIA

Two cases of ileal perforation in preterm infants treated with high-do se dexamethasone for bronchopulmonary dysplasia are described, Cortico steroid-induced gastroduodenal haemorrhage or perforation has been wel l documented, but less known to most clinicians is that the lower gast rointestinal tract can also be involved. Unlike previous reported case s in which affected infants deteriorated rapidly and became moribund w ithin hours of onset of symptoms, ''silent'' perforations detected on routine radiograph or escaping clinical recognition until at an advanc ed stage can be the initial presentation. The need for greater vigilan ce and a low threshold for abdominal investigations are emphasised in preterm infants treated with dexamethasone.