Cocaine-induced mesenteric ischaemia requiring small bowel resection

Cocaine use causes profound vasoconstriction leading to various systemic complications. Gastrointestinal complications such as mesenteric ischaemia are difficult to recognise and may result in serious consequences if not treated promptly. We report on the case of a 47-year-old man presenting with me...

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Bibliographic Details
Published in:BMJ case reports 2021-01, Vol.14 (1), p.e238593
Main Authors: Veloso Costa, Asya, Zhunus, Asiya, Hafeez, Rehana, Gupta, Arsh
Format: Article
Language:English
Subjects:
Abdomen
Blood clots
Blood tests
Case Report
Case reports
Cocaine
Cocaine-Related Disorders - complications
Digestive System Surgical Procedures
Edema
Fistula
Hemoglobin
Humans
Intensive care
Ischemia
Laparotomy
Male
Mesenteric Vascular Occlusion - etiology
Mesenteric Vascular Occlusion - surgery
Middle Aged
Ostomy
Pain
Patients
Recreational drugs
Risk factors
Small intestine
Surgery
Thrombosis
Young adults
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Summary:Cocaine use causes profound vasoconstriction leading to various systemic complications. Gastrointestinal complications such as mesenteric ischaemia are difficult to recognise and may result in serious consequences if not treated promptly. We report on the case of a 47-year-old man presenting with mesenteric ischaemia on a background of acute on chronic cocaine consumption, where diagnosis was not evident until second presentation. He underwent an emergency laparotomy with small bowel resection and jejunostomy formation and made a good recovery with eventual reversal surgery. The literature on cocaine-induced bowel ischaemia shows significant variability in presentation and outcome. Laboratory investigations are non-specific, and early recognition is vital. Given the increasing recreational use of cocaine in the UK, it is imperative to have a high clinical index of suspicion for mesenteric ischaemia in patients presenting with non-specific abdominal pain, and to ensure a detailed social history covering recreational drug use is not forgotten.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2020-238593