Outcomes of cocaine-induced gastric perforations repaired with an omental patch.
Crack cocaine has been associated with acute gastric perforation. The appropriate surgical treatment and long-term outcomes remain unclear. A retrospective chart review of all gastroduodenal perforations associated with crack cocaine use was performed. Data abstracted included details of short- and long-term outcomes. Kaplan-Meier methods were used to evaluate surgical outcomes. Over the 14-year period ending December 2005, 16 cases of crack-induced gastric perforations were identified. Most (75%) were treated with an omental patch. The other patients underwent a formal antiulcer operation, including one vagotomy and pyloroplasty (V&P), one vagotomy and antrectomy, one subtotal gastrectomy, and one ulcer excision and V&P. All patients after antiulcer procedures were followed for a median of 63 months (range 27-120) with no recurrences. Follow-up data were available in 75% of the omental patch patients. Recurrence of disease was observed in 56% of these omental patch patients at a median of 20 months (range 11-39). Those without recurrence were followed for a median of 67 months (range 12-96). The recurrence rate was borderline lower in the antiulcer group (P = 0.072). Omental patch closure results in a recurrence rate over 50% compared with no recurrence for formal antiulcer procedures.
Schuster
Kevin M
KM
Division of Trauma, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, USA. kevin.schuster@yale.edu
Feuer
William J
WJ
Barquist
Erik S
ES
D019970:Cocaine-Related Disorders / Q000150:complications*; D016578:Crack Cocaine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000637:transplantation*; D010439:Peptic Ulcer Perforation / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
D016578:Crack Cocaine
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