Acute abdomen in drug abusers

Introduction: Acute abdomen is one of the most important issues in abdominal surgery. Our study aims to describe the differences in clinical presentation of patients, in the course of their hospitalization, and in morbidity and mortality of patients with drug abuse; another aim is to describe our own experience with drug abusers with acute abdomen. Method: Patients with the history of drug abuse and with non-traumatic acute abdomen were included retrospectively to our set. We chose patients hospitalized between 2013 and 2018. We analyzed the demographical data of the patients, types of abused drugs, concordance between the first and final diagnosis, findings of paraclinical examinations, the need of surgical treatment, and the type of surgery. Morbidity, mortality and the length of hospital stay were tracked. All the data was evaluated using descriptive statistics. Results: 8 patients (4.7 per mille of all the patients hospitalized for acute abdomen) fulfilled the criteria of our study. All the patients were men with median age 32 years. Pervitin (methamphetamine) was the most frequently abused drug (in 50%), followed by heroin, benzodiazepines, tetrahydrocannabinol, subutex, hypnotics and tramadol. Peptic ulcer perforation was the most frequent diagnosis in our set (in 50% of all patients). The other diagnoses included: two cases of upper gastrointestinal tract bleeding, one case of Crohn’s disease relapse with peritonitis and one case of colitis of the ascending colon. Surgical treatment was necessary in 75% patients. 30-day mortality was zero; an early complication (wound dehiscence) developed in one operated patient. Mean length of hospital stay was 9.7 days in our set, with the median of 7 days. Conclusion: Drug abusers represent only a marginal part of all patients with acute abdomen. This group is characterized by a significantly lower age, by a considerable predominance of men and by the preference of perforated peptic ulcer.