Muñiz A E, Evans T
Department of Emergency Medicine and Pediatrics, Medical College of Virginia of Virginia Commonwealth University, Richmond, VA 23298-0401, USA.
Am J Emerg Med. 2001 Jan;19(1):61-3. doi: 10.1053/ajem.2001.20010.
Crack, the free-base form of cocaine, causes pulmonary, cardiac, obstetric, neurologic, musculoskeletal, and gastrointestinal complications. As the popularity for crack use increases, it follows that the number of cocaine-related emergency department (ED) visits, hospitalizations, and deaths should increase. We report 3 cases of patients arriving to the ED with acute onset of abdominal pain after smoking crack. These patients required surgical correction of their intestinal perforations. Although the exact pathophysiology of intestinal ischemia is not known, cocaine blocks the reuptake of norepinephrine, which leads to mesenteric vasoconstriction and focal tissue ischemia that may lead to perforation. The chronologic relationship of crack consumption to gastrointestinal perforation leads us to surmise that a possible crack-related ischemic event is the cause of perforation in these patients. Physicians examining patients with abdominal pain should be aware of the potential gastrointestinal complications of crack and consider bowel ischemia whenever a cocaine abuser presents with abdominal pain.
快克可卡因（可卡因的游离碱形式）会引发肺部、心脏、产科、神经、肌肉骨骼及胃肠道并发症。随着快克可卡因使用的增多，与可卡因相关的急诊就诊、住院及死亡人数也应随之增加。我们报告3例吸食快克可卡因后急性腹痛前来急诊的患者。这些患者需要手术修复肠道穿孔。尽管肠道缺血的确切病理生理学尚不清楚，但可卡因会阻止去甲肾上腺素的再摄取，从而导致肠系膜血管收缩和局部组织缺血，进而可能导致穿孔。快克可卡因吸食与胃肠道穿孔的时间关系使我们推测，这些患者穿孔的原因可能是与快克可卡因相关的缺血事件。检查腹痛患者的医生应意识到快克可卡因潜在的胃肠道并发症，并在可卡因滥用者出现腹痛时考虑肠道缺血的可能性。
