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Thoracolumbar compression fractures presenting with an acute ileus
E L Treadwell1, P R Cunningham, H M Kowalski
1Department of Medicine, School of Medicine, East Carolina University, Greenville, NC 27858-4354.
Journal of the National Medical Association
|September 1, 1990
Summary
Long-term corticosteroid use for connective tissue diseases can cause osteoporosis and spine compression fractures. Consider these fractures in elderly patients with acute abdomen and back pain after corticosteroid therapy.
Area of Science:
- Rheumatology
- Endocrinology
- Geriatrics
Background:
- Corticosteroids are standard treatment for connective tissue diseases like systemic lupus erythematosus.
- Long-term corticosteroid use is associated with osteoporosis and potential vertebral fractures.
Observation:
- An elderly patient with systemic lupus erythematosus on long-term corticosteroids presented with acute abdomen and minimal back pain.
- Initial investigations, including exploratory laparotomy, ruled out intra-abdominal pathology.
- Subsequent spinal imaging revealed multiple compression fractures (T12, T8, L4).
Findings:
- The patient's symptoms resolved with conservative management.
- This case highlights a potential complication of long-term corticosteroid therapy.
Implications:
- Vertebral compression fractures should be considered in the differential diagnosis of acute abdomen in elderly patients on long-term corticosteroids.
- Early recognition and conservative management can lead to symptom resolution.