Department of General Surgery, Princess Royal University Hospital, King's College Hospital NHS Foundation Trust, London, UK
Department of General Surgery, Princess Royal University Hospital, King's College Hospital NHS Foundation Trust, London, UK.
BMJ Case Rep. 2021 Jan 12;14(1):e238593. doi: 10.1136/bcr-2020-238593.
Cocaine use causes profound vasoconstriction leading to various systemic complications. Gastrointestinal complications such as mesenteric ischaemia are difficult to recognise and may result in serious consequences if not treated promptly. We report on the case of a 47-year-old man presenting with mesenteric ischaemia on a background of acute on chronic cocaine consumption, where diagnosis was not evident until second presentation. He underwent an emergency laparotomy with small bowel resection and jejunostomy formation and made a good recovery with eventual reversal surgery. The literature on cocaine-induced bowel ischaemia shows significant variability in presentation and outcome. Laboratory investigations are non-specific, and early recognition is vital. Given the increasing recreational use of cocaine in the UK, it is imperative to have a high clinical index of suspicion for mesenteric ischaemia in patients presenting with non-specific abdominal pain, and to ensure a detailed social history covering recreational drug use is not forgotten.
可卡因使用会导致严重的血管收缩，从而引发各种全身并发症。胃肠道并发症，如肠系膜缺血，难以识别，如果不及时治疗，可能会导致严重后果。我们报告了一例 47 岁男性的病例，他在急性和慢性可卡因使用的背景下出现肠系膜缺血，直到第二次就诊时才明确诊断。他接受了紧急剖腹手术，进行了小肠切除术和空肠造口术，最终恢复良好并进行了逆转手术。关于可卡因引起的肠缺血的文献表明，其表现和结果存在显著差异。实验室检查是非特异性的，早期识别至关重要。鉴于可卡因在英国的娱乐性使用不断增加，对于出现非特异性腹痛的患者，必须高度怀疑肠系膜缺血，并确保不会忘记包含娱乐性药物使用的详细社会史。
