Nonsteroidal anti-inflammatory medications, such as aspirin or ibuprofen, place patients at risk for the complications of peptic ulcer disease, including bleeding, obstruction, and perforation.
Corticosteroids may mask classic signs of inflammation, such as fever and peritoneal irritation, making the abdominal examination less reliable.
Antibiotics consumed by patients may aid or hinder diagnosis.
Patients with peritonitis may have decreased pain.
Patients who have diarrhea and abdominal pain may have antibiotic-induced pseudomembranous colitis caused by Clostridium difficile.
Be aware of the elderly patient on immunosuppressants or antibiotics.