Case Report

Cocaine-Associated Ischemic Colitis

Authors: JEFFREY D. LINDER, MD, KLAUS E. MÖNKEMÜLLER, MD, ISAAC RAIJMAN, MD, LAWRENCE JOHNSON, MD, AUDREY J. LAZENBY, MD, MEL C. WILCOX, MD

Abstract

ABSTRACT: &NA; 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.

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References