Serous peritonitis in adult Still's syndrome

Serous peritonitis may be an underrecognized feature of adult Still's syndrome. An illustrative case with pathologic findings is presented. Serous peritonitis generally occurs during an acute multisystem flare of Still's syndrome. Peritoneal signs, abdominal distension, and radiographic air fluid levels in the small bowel may suggest incomplete bowel obstruction. Corticosteroids and supportive management are often effective although surgical lysis of adhesions may be required.