[Heroin addiction and surgical abdominal pain: report of three cases]

Three cases of heroin addiction having a syndrome of acute abdominal pain with features of perforation of viscus or peritonitis were reported. In each patient, acute abdominal pain was originally attributed to perforation of either appendicitis or peptic ulcer requiring immediate surgical intervention. However, symptoms resolved rapidly in all patients after a period of observation with administration of Dolantin. This narcotic bowel syndrome (NBS) is a clinically important and frequently unrecognized cause of acute abdominal pain. The mechanism of acute abdominal pain and the key paints in differential diagnosis and treatment of NBS were discussed. It is stressed that the possibility of NBS should be considered in heroin addicts by surgeons, physicians, gynecologists, obstetricians and anesthesiologists.