Severe intestinal pseudo-obstruction following withdrawal from over-the-counter steroid abuse

Relative adrenal insufficiency (RAI) is commonly diagnosed in critically ill patients failing to maintain a pressor response and/or with electrolyte abnormalities. We report a case of a 59-year-old man who presented with diverticular bleeding and developed prolonged ileus postoperatively. After obse...

Full description

Saved in:
Bibliographic Details
Published in:Journal of postgraduate medicine (Bombay) 2011-07, Vol.57 (3), p.218-220
Main Authors: Sharma, A, Naraynsingh, V, Goalan, R, Teelucksingh, S T
Format: Article
Language:English
Subjects:
Adrenal glands
Adrenal insufficiency
Adrenal insufficiency, ileus, pseudo-obstruction, self-medication
Care and treatment
Case studies
Complications and side effects
Diagnosis
Inflammatory bowel disease
Intestines
Medical diagnosis
Mortality
Obstructions
Steroids (Drugs)
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Relative adrenal insufficiency (RAI) is commonly diagnosed in critically ill patients failing to maintain a pressor response and/or with electrolyte abnormalities. We report a case of a 59-year-old man who presented with diverticular bleeding and developed prolonged ileus postoperatively. After observing arthritic joints on examination, further questioning revealed long-term, high-dose steroid use for analgesic effect. Failure to produce an effective cortisol response was due to adrenal suppression from continuous steroid use. Immediate improvement of his ileus was seen after steroid replacement. Unreported self-medication is a frequent problem encountered in developing countries. RAI can be easily missed and requires a high index of suspicion in any patient who fails to respond to conventional treatment or with long-term steroid use.
ISSN:0022-3859
0972-2823
DOI:10.4103/0022-3859.85212