ISCHEMIC COLITIS RELATED TO COCAINE ABUSE

It is well recognized that cocaine use can be associated with serious cardiovascular complications, including myocardial infarction. Several case reports have recently linked the use of cocaine with ischemic ev ents of the small bowel and colon. We report a case of ischemic coliti s complicated by perforation in a 47-yr-old diabetic man which occurre d after recreational cocaine use. The older age of the patient and und erlying diabetes mellitus were unique aspects of our case, compared wi th others reported in the literature. The patient's history of cocaine use was not initially identified. After we obtained a negative arteri ogram result, we went back to the patient and the information was reve aled. The literature regarding intestinal ischemia related to cocaine and other drugs/medications is reviewed. The abuse of cocaine should b e considered in the differential diagnosis of acute intestinal vascula r insufficiency syndromes.