Peritonitis on sigmoidal perforation in a cocaine user: A rare case report

Cocaine, the second most abused drug in Morocco after cannabis, has been associated with multiple cardiac, pulmonary, neurological, and digestive complications. Colonic perforation following cocaine abuse is relatively lesser-known and requires attention as abuse rates are increasing, and existing e...

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Bibliographic Details
Published in:International journal of surgery case reports 2024-02, Vol.115, p.109287, Article 109287
Main Authors: Mabrouk, Mohamed Yassine, Guellil, Abdelali, Haitam, Soussan, Deflaoui, Tarik, Jabi, Rachid, Bouziane, Mohammed
Format: Article
Language:English
Subjects:
Case Report
Cocaine
Colonic ischemia
Peritonitis
Surgery
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Summary:Cocaine, the second most abused drug in Morocco after cannabis, has been associated with multiple cardiac, pulmonary, neurological, and digestive complications. Colonic perforation following cocaine abuse is relatively lesser-known and requires attention as abuse rates are increasing, and existing evidence is scarce. Only a few cases have been reported in medical literature. We report the case of a 42-year-old male cocaine addict who presented with acute peritonitis. A laparotomy revealed a 3 cm perforation in the sigmoid, The absence of radiological, biological, and pathological evidence confirms the toxic origin of the perforation. Cocaine-induced ischemic colitis is a rare occurrence in a surgeon's clinical experience. This condition is typically confirmed through colonoscopy and often resolves without the need for surgery, although a small number of cases may advance to peritonitis, necessitating surgical intervention. Cocaine's adverse effects should be taken into account in the differential diagnosis of acute ischemic events in young adults. A general understanding of the significant complications associated with cocaine can aid in achieving early diagnosis and prompt treatment. •Digestive perforation is a rare but serious complication of cocaine user.•Peritonitis by spontaneous colonic perforation of the digestive tract is the most serious complication.•The possible cocaine-related ischemic event is the cause of perforation in these patients.•For acute abdominal pain in cocaine users, consider digestive perforation in the emergency department•Early exploratory laparotomy may be the first-line treatment.•Prevention is better than cure
ISSN:2210-2612
2210-2612
DOI:10.1016/j.ijscr.2024.109287