Acute pancreatitis secondary to cocaine use: a case-based systematic literature review

Abstract

Cocaine use continues to be an important global public health problem. As the use of cocaine remains pervasive so have a myriad of adverse events associated with this drug. These deleterious effects are well-studied, but gastrointestinal complications remain esoteric and the existing clinical evidence is scarce. Ischemia of the esophagus and small bowel, perforation, peptic ulceration, gastrointestinal bleeding, and ischemic colitis are among the reported complications. In specific, acute pancreatitis secondary to cocaine use is an exceedingly rare clinicopathologic entity. To date, only 7 cases of this condition have been reported in the English-language literature. We hereby delineate a rare case of a 29-year-old female who developed her first episode of cocaine-associated pancreatitis. The diagnosis was made based on a standard battery of investigations and meticulous exclusion of common etiologies of acute pancreatitis. To our knowledge, this case represents the first report of re-occurrence of acute pancreatitis upon subsequent crack cocaine insufflation, adding a higher level of evidence to a fallible association. We also present a systematic review of the existing literature on acute pancreatitis following cocaine use. An updated knowledge regarding this rare association is of paramount importance for early diagnosis and astute management.

Pancreatitis aguda asociada a cocaína, una complicación inusual. Serie de casos

“…Los dos se manejaron con líquidos, vasopresores, analgesia y suspensión de la vía oral 10 . Se recalca que el cese permanente de la cocaína es imperativo en términos de tratamiento como medida adicional a las estrategias de soporte administrados en concomitantemente 16 .…”

“…Finalmente, en el 2021 Goraya MHN et al publican una revisión sistemática de la literatura basada en casos, que señalan características similares en cuanto a presentación clínica e historia de la enfermedad, destacando en dichos pacientes el trastorno por uso de múltiples sustancias en el 57% de los casos y el desarrollo de los síntomas 48 horas posteriores a la exposición a la cocaína en el 86% de los pacientes 16 .…”

Acute Pancreatitis Secondary to Cocaine Intoxication: A Case Series

“…Cocaine use has been consistently linked with severe medical complications [2]. Among the most prevalent are cardiovascular effects, encompassing disruptions in cardiac rhythm and incidents of myocardial infarction [3,4]; neurological manifestations, including but not limited to headaches, seizures, cerebral vascular accidents, and states of coma [5]; and gastrointestinal disturbances, such as abdominal pain and emetic symptoms [6][7][8][9][10][11][12]. Notably, instances of sudden death have been documented, with fatalities often attributed to cardiac arrhythmias or convulsive episodes [3].…”

Are Cytomorphogenetic Events Correlated with Oral Mucosal Lesions Induced by Crack Cocaine Use? A Systematic Review

“…Even though several studies have approached the body effect of high consumption of crack cocaine [8][9][10], there is still minimal knowledge of its harmful effects on oral mucosal cells at the cellular and molecular level. In line with this limitation, this systematic review aimed to answer the following question: Are cytomorphogenetic events correlated with oral mucosal lesions induced by crack cocaine use?…”