Rare cause of acute abdomen–cocaine-induced small intestinal perforation with coexisting lower gastrointestinal bleed: an unusual presentation

Abstract

Cocaine, an alkaloid, is an addictive drug and its abuse as a recreational drug is on the increasing side with its associated complications. Gastrointestinal complications, after cocaine abuse, are less known and need to be addressed since the abuse is on the rise and the existing evidence is scarce. We report a case of a 22-year-old male patient who presented with abdominal pain following a cocaine injection. On examination, signs of peritonitis were noted and laparotomy revealed a 2×1 cm perforation in the distal ileum. The unhealthy intestinal segment was resected and taken out as a double-barrel ileostomy. The patient had an episode of severe lower gastrointestinal bleeding on postoperative day 6. CT and colonoscopy revealed signs of ischaemic bowel and tissue biopsy showed oedematous, inflamed and haemorrhagic bowel mucosa. The patient was managed conservatively and is doing well under follow-up in a de-addiction centre.

Fatal peritonitis due to gastric perforation in a male heroin addict: A case report and literature review

“…After the surgical removal of the affected ileum, the patient experienced substantial lower gastrointestinal bleeding six days post-operation. A subsequent colonoscopy revealed indications of intestinal ischemia, while a tissue biopsy exhibited inflamed, edematous, and bleeding intestinal mucosa [ 15 ].…”

Upper gastrointestinal bleeding from gastric antral vascular ectasia following cocaine use: case presentation and review of literature

“…Specific vascular GI complications that have been noted in the setting of cocaine use include small bowel bleeding, colonic bleeding, and bowel perforation. [9] There is a definite consensus on the use of cocaine as both a trigger of GI bleeding and an exacerbating factor in patients predisposed to GI bleeding, such as those with history of GI disease.…”

Cocaine: An Updated Overview on Chemistry, Detection, Biokinetics, and Pharmacotoxicological Aspects including Abuse Pattern

“…Furthermore, despite the global COVID-19 pandemic, European authorities have intercepted at seaports growing amounts of cocaine in 2020 [5]. All the while, case reports detailing the harmful consequences of cocaine use abound [7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”