Intestinal Ischemia Due to Methamphetamine Abuse in a Confused Elderly Patient: A Case Report

Bowel ischemia is a critical entity that mandates an early and proper diagnosis. Causes of bowel ischemia are numerous, yet, identifying and treating the exact cause is challenging. Methamphetamine-induced bowel ischemia is rare but of clinical significance due to its high disease burden. We describe a case of a 67-year-old man who presented with colicky abdominal pain shortly after methamphetamine intake. CT angiography was done and failed to show occlusive causes, which pointed to a non-occlusive cause of bowel ischemia. The patient was hemodynamically stable on admission. Diagnostic laparoscopy was converted to laparotomy; segmental gangrene of both the small and large bowels was found. Resection of the ischemic part was done. The patient improved and was hemodynamically stable postoperatively. In conclusion, a holistic approach to patient history and physical examination can grab attention to unusual pathologies that lead to early intervention and fastened life-saving measures. Questions about stimulant drug use are crucial not only in younger patients but in older patients as well. In this case, we highlight the surgical, medical, and mental aspects of methamphetamine abuse in the elderly population.