title: Massive portal venous air and pneumatosis intestinalis associated with cocaine-induced mesenteric ischemia.
abstract: BACKGROUND
  We report a 53-year-old female who presented to the emergency department in distress with an acute abdomen after recreational use of cocaine.
  
  
  CONCLUSIONS
  The patient's computed tomography scan revealed extensive portal venous air with small-bowel pneumatosis intestinalis resulting from intestinal ischemia. Air could be seen throughout the superior mesenteric vein, portal vein, and hepatic portal venous distribution. The patient underwent extensive resuscitation and resection of small bowel requiring three operative interventions. A pertinent review of the literature of cocaine-induced small-bowel ischemia is provided covering the pathophysiology, clinical findings, and epidemiology.
  
  
  CONCLUSIONS
  Cocaine-induced mesenteric ischemia is a serious disease causing significant morbidity and mortality. Operative therapy is often required.
authors.affiliation: Department of Surgery, Thomas Jefferson University, 1015 Walnut Street, Curtis Bldg., Suite 620, Philadelphia, PA 19107, USA. rittenhouse77@gmail.com
authors.forename: David W
authors.initials: DW
authors.lastname: Rittenhouse
authors.forename: Karen A
authors.initials: KA
authors.lastname: Chojnacki
mesh_terms: D019970:Cocaine-Related Disorders / Q000150:complications*; D004618:Embolism, Air / Q000209:etiology; D005260:Female; D006801:Humans; D007082:Ileum / Q000098:blood supply / Q000601:surgery; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D007583:Jejunum / Q000098:blood supply / Q000601:surgery; D008641:Mesenteric Vascular Occlusion / Q000209:etiology*; D008642:Mesenteric Veins; D008875:Middle Aged; D011006:Pneumatosis Cystoides Intestinalis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D011169:Portal Vein; D011859:Radiography