Fabra Isabel, Roig José Vicente, Sancho Cristina, Mir-Labrador José, Sempere Javier, García-Ferrer Luis
Servicio de Cirugía General y del Aparato Digestivo, Consorcio Hospital General Universitario de Valencia, Valencia, Spain.
Gastroenterol Hepatol. 2011 Jan;34(1):20-3. doi: 10.1016/j.gastrohep.2010.10.005. Epub 2011 Jan 14.
Drug consumption is among the non-occlusive causes of ischemic colitis. We report a case of cocaine-induced ischemic colitis in a 34-year-old man who had undergone sigmoid resection and loop colostomy due to abdominal-pelvic injury 3 months previously. The patient presented with abdominal pain associated with diarrhea and slight transient fever of doubtful etiology and reported intranasal cocaine consumption. He was hemodynamically stable and showed no peritoneal irritation. Traces of blood were found in the colostomy bag. Colonoscopy showed ulcers and necrosis proximal to the stoma. Computed tomography angiography scan showed no abnormalities except filiform inferior mesenteric artery. The symptoms were self-limiting and the patient was discharged 3 days after admission. Subsequently the colostomy was closed without complications. A high degree of suspicion is required in young patients with abdominal pain not identified by conventional methods and a recent history of drug consumption.
药物滥用是缺血性结肠炎的非阻塞性病因之一。我们报告一例34岁男性因3个月前腹部盆腔损伤行乙状结肠切除及袢式结肠造口术，后发生可卡因诱发的缺血性结肠炎。患者出现腹痛伴腹泻及病因不明的轻微短暂发热，并自述有鼻内使用可卡因史。其血流动力学稳定，无腹膜刺激征。结肠造口袋内发现少量血迹。结肠镜检查显示造口近端有溃疡和坏死。计算机断层血管造影扫描显示除肠系膜下动脉呈丝状外无异常。症状为自限性，患者入院3天后出院。随后结肠造口关闭，无并发症。对于常规方法无法明确病因且近期有药物滥用史的腹痛年轻患者，需要高度怀疑。
