STEVEN BROZINSKY, M.D.
To the editor: In their analysis of plain abdominal radiographs in the diagnosis of abdominal pain Eisenberg and associates (1) state that "patients with inflammatory bowel disease or toxic megacolon almost always have moderate or severe abdominal tenderness, often with bloody diarrhea, by the time radiographic abnormalities can be detected." The authors fail to consider inflammatory bowel disease patients who may already be on high doses of corticosteroids when they present with abdominal pain. I have seen progressive, toxic dilitation of the colon on serial plain films with absolutely no change in the clinical findings of these patients. That daily
BROZINSKY S. Abdominal Films and Corticosteroid Treatment. Ann Intern Med. ;97:786. doi: 10.7326/0003-4819-97-5-786_2
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Published: Ann Intern Med. 1982;97(5):786.
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