[Perforation of colonic diverticulum under corticoids: a complication to be known and recognized]

Glucocorticoids can produce acute perforation of colonic diverticula and 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 ultrasans. Residues of contrast liquid, after an earlier X-ray exploration, have made the diagnosis of diverticula easier. In one case, corticosteroids were started as a short cure for the treatment of a myeloma. In the other case, patient received a long term corticosteroid therapy at low dose for an asthmatic disease. The perforation was induced by an increased dosage. Diverticular perforations result from inhibition of synthesis of prostaglandins who have the beneficial property of "cytoprotection" and from the immunosuppressive action of glucocorticoids which favour the diffusion of the peritoneal infection. diffusion of the peritoneal infection.