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Published on: October 29, 2014
Cocaine-induced mesenteric ischaemia requiring small bowel resection
Asya Veloso Costa1, Asiya Zhunus2, Rehana Hafeez2
1Department of General Surgery, Princess Royal University Hospital, King's College Hospital NHS Foundation Trust, London, UK asya.velosocosta@nhs.net.
BMJ Case Reports
|January 13, 2021
Summary
Cocaine use can cause mesenteric ischemia, a serious gastrointestinal complication. Early recognition and a detailed patient history are crucial for timely diagnosis and treatment of this condition.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Toxicology
Background:
- Cocaine use is associated with significant systemic complications, including profound vasoconstriction.
- Gastrointestinal complications, such as mesenteric ischemia, are a severe consequence of cocaine use.
- Mesenteric ischemia can lead to serious outcomes if not promptly diagnosed and treated.
Observation:
- A case of a 47-year-old male with acute-on-chronic cocaine consumption presented with mesenteric ischemia.
- The diagnosis of mesenteric ischemia was delayed, requiring a second presentation for clear identification.
- The patient underwent emergency laparotomy, small bowel resection, and jejunostomy formation, with a subsequent good recovery and reversal surgery.
Findings:
- Literature review reveals significant variability in the presentation and outcomes of cocaine-induced bowel ischemia.
- Laboratory investigations for cocaine-induced mesenteric ischemia are often non-specific.
- Early clinical recognition of mesenteric ischemia in patients with a history of cocaine use is vital.
Implications:
- Increasing recreational cocaine use in the UK necessitates a high index of suspicion for mesenteric ischemia in patients with non-specific abdominal pain.
- Thorough social history, including recreational drug use, is essential for diagnosing cocaine-induced mesenteric ischemia.
- Prompt diagnosis and intervention are critical to improve outcomes for patients with cocaine-induced mesenteric ischemia.
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