Cocaine-associated ischemic colitis.
Cocaine use can result in various gastrointestinal complications, including gastric ulcerations, retroperitoneal fibrosis, visceral infarction, intestinal ischemia, and gastrointestinal tract perforation. We report cocaine-associated colonic ischemia in three patients and review the literature. Including ours, 28 cases have been reported, with a mean patient age of 32.6 years (range, 23 to 47 years); 53.5% were men and 46.5% were women. The interval between drug ingestion and onset of symptoms varied from 1 hour to 2 days. Cocaine is a potentially life-threatening cause of ischemic colitis and should be included in the differential diagnosis of any young adult or middle-aged patient with abdominal pain and bloody diarrhea, especially in the absence of estrogen use or systemic disorders that can cause thromboembolic events, such as atrial fibrillation.
Linder
J D
JD
Department of Medicine, University of Alabama at Birmingham, USA.
Mönkemüller
K E
KE
Raijman
I
I
Johnson
L
L
Lazenby
A J
AJ
Wilcox
C M
CM
D015746:Abdominal Pain / Q000139:chemically induced; D000328:Adult; D019970:Cocaine-Related Disorders / Q000150:complications*; D017091:Colitis, Ischemic / Q000139:chemically induced*; D016578:Crack Cocaine / Q000009:adverse effects*; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000139:chemically induced; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D012812:Sigmoidoscopy; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D016578:Crack Cocaine