Cocaine-associated ischemic colitis

Cocaine use can result in various gastrointestinal complications, including gastric ulcerations, retroperitoneal fibrosis, visceral infarction, intest inal ischemia, and gastrointestinal tract perforation. We report cocaine-as sociated colonic ischemia in three patients and review the Literature. Incl uding ours, 28 cases have been reported, with a mean patient age of 32.6 ye ars (range, 23 to 47 years); 53.5% were men and 46.5% were women. The inter val between drug ingestion and onset of symptoms varied from 1 hour to 2 da ys. Cocaine is a potentially life-threatening cause of ischemic colitis and should be included in the differential diagnosis of any young adult or mid dle-aged patient with abdominal pain and bloody diarrhea, especially in the absence of estrogen use or systemic disorders that can cause thromboemboli c events, such as atrial fibrillation.