RT Journal Article
SR Electronic
T1 Cocaine-induced mesenteric ischaemia requiring small bowel resection
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e238593
DO 10.1136/bcr-2020-238593
VO 14
IS 1
A1 Asya Veloso Costa
A1 Asiya Zhunus
A1 Rehana Hafeez
A1 Arsh Gupta
YR 2021
UL http://casereports.bmj.com/content/14/1/e238593.abstract
AB 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.