title: Bowel ischaemia and cocaine consumption; case study and review of the literature.
abstract: BACKGROUND
  Amongst others, cocaine consumption has a detrimental effect in the vascular supply to the mesenteric area causing abdominal ischemic changes. Early recognition of these changes and adequate treatment are essential to avoid serious complications and possible death of the patient from sepsis.
  
  
  METHODS
  In this case study, the subject is a 40-years-old gentleman presenting with acute abdominal pain due to multiple ischemic changes in both small bowel and sigmoid loops. The patient required emergency surgical intervention consisting of bowel resection and anastomosis. The pathologic analysis of the segment showed transmural necrosis and necrotizing phlebitis caused by the ingestion of drugs or toxic agents. The patient later confirmed the habitual consumption of cocaine.
  
  
  CONCLUSIONS
  The increase in cocaine consumption and other recreational toxins substructed from erythroyilon coca alkaloids amongst young people have generated a large number of admissions to Hospital Accident and Emergency Departments with patients complaining of acute abdominal pain. In many of these cases, surgical intervention is required and in some cases patients will sadly die without a proper diagnosis. Some of the most common effects of cocaine and its compounds includes; hollow viscus perforation, gastro-intestinal bleed, and other vascular problems such as enteritis and ischemic colitis. It appears clear that there is a great need for an advance history taking of these patients and their habit to cocaine and other drugs together with a urine test for drug screening. These together with a suspicion of a non- occlusive ischemic bowel caused by the effects of cocaine in young adults with no cardiac risk factors will guide clinicians and establish, and plan the correct treatment for these categories of patients.
authors.forename: Almudena
authors.initials: A
authors.lastname: Martínez-Vieira
authors.forename: Alonso
authors.initials: A
authors.lastname: Camacho-Ramírez
authors.forename: Antonio
authors.initials: A
authors.lastname: Díaz-Godoy
authors.forename: Antonio
authors.initials: A
authors.lastname: Calvo-Durán
authors.forename: Carmen María
authors.initials: CM
authors.lastname: Pérez-Alberca
authors.forename: Coral
authors.initials: C
authors.lastname: de-la-Vega-Olías
authors.forename: Gloria
authors.initials: G
authors.lastname: Muñoz-Arias
authors.forename: Manuel
authors.initials: M
authors.lastname: Balbuena-García
authors.forename: Assad
authors.initials: A
authors.lastname: Najeb
authors.forename: Vicente
authors.initials: V
authors.lastname: Vega-Ruiz
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000150:complications*; D006801:Humans; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000139:chemically induced*; D008297:Male