Perforation of bowel during treatment of ulcerative colitis with corticotropin; report of three cases.

Corticotropin (ACTH) and, to a lesser extent, cortisone have recently been used in the treatment of nonspecific ulcerative colitis. As with other drugs used in the treatment of this disease, the results have varied widely. Pronounced improvement has been noted in some cases during corticotropin or cortisone therapy,1but only brief mention has been made of peritonitis and perforation during the course of therapy.1a,dOther reports on corticotropin or cortisone therapy have described the perforation of peptic ulcers during treatment.2Perforations of the small intestine have been reported in one patient with regional enteritis.1a It is our purpose to report three cases of peritonitis occurring among 17 patients with ulcerative colitis treated by us with corticotropin. Thirteen patients received 25 mg. of corticotropin every six hours intramuscularly for 17 to 30 days. Four patients received 20 mg. each day by continuous infusion over an eight hour