Multiple Ulcerations and Perforations of the Jejunum and Ileum Complicating Prednisone Therapy

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Abstract
Corticotropic hormones and adrenal corticosteroids have proven to be the sine qua non of replacement therapy in certain pituitary and adrenal gland disorders. Although not a therapeutic panacea, the value of the induced hyperadrenal state in many additional illnesses has been established. Unfortunately, the occurrence of occasional deleterious side-reactions and untoward symptoms of overdosage have established their action to be as that of a "two-edged sword." Among the complications of corticotropin and adrenal cortical hormone therapy, none are associated with a graver morbidity or higher mortality than are those involving the gastrointestinal system. The appearance of ulcerations of the duodenum and stomach with a high incidence of perforation and hemorrhage has been recognized with increased frequency and has led to a curtailment in the use of hormone therapy and to the use of a prophylactic ulcer regimen in cases where such therapy is mandatory. The hormones have resulted in the

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