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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients present to emergency departments with a variety of complications related to cocaine abuse. Emergency physicians must be aware of the life- and limb-threatening complications to avoid undue mortality and morbidity. We present the case of a patient with aortic dissection who developed the acute onset of abdominal pain 5 minutes after subcutaneous cocaine use. Four previous reports of cocaine-associated aortic dissection are reported in the literature. These cases and other reports of intra-abdominal vascular injuries related to cocaine use are reviewed. Cocaine's mechanism of action as it relates to aortic dissection and some of the pharmacologic agents available for treatment are discussed.
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PMID:Cocaine-associated dissection of the thoracic aorta. 149 Nov 55

Cocaine use can result in various gastrointestinal complications, including gastric ulcerations, retroperitoneal fibrosis, visceral infarction, intestinal ischemia, and gastrointestinal tract perforation. We report cocaine-associated colonic ischemia in three patients and review the literature. Including ours, 28 cases have been reported, with a mean patient age of 32.6 years (range, 23 to 47 years); 53.5% were men and 46.5% were women. The interval between drug ingestion and onset of symptoms varied from 1 hour to 2 days. Cocaine is a potentially life-threatening cause of ischemic colitis and should be included in the differential diagnosis of any young adult or middle-aged patient with abdominal pain and bloody diarrhea, especially in the absence of estrogen use or systemic disorders that can cause thromboembolic events, such as atrial fibrillation.
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PMID:Cocaine-associated ischemic colitis. 1100 54

Cocaine use is common and is associated with gastrointestinal complications that can present as a surgical abdomen. We report a case of a previously healthy 25-year-old man who presented to the Emergency Department with severe abdominal pain and vomiting after using IV cocaine. Exploratory celiotomy revealed massive free intraperitoneal (IP) clotted blood with no evidence of underlying pathology. This unusual case underscores the possibility of life-threatening hemorrhage in cocaine consumers.
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PMID:The surgical abdomen associated with cocaine abuse. 1248 20

Cocaine use is now relatively common in the occidental societies and is responsible for a long list of medical complications involving almost every organ system in the body. The digestive complications are less known. We report a case of a young man who presented to the emergency department with violent abdominal pain and several episodes of vomiting after using intranasal cocaine. The abdominal pain was caused by a massive haemoperitoneum with no evidence of any underlying pathology. This case shows that we have to consider the possibility of a lethal abdominal haemorrhage in the differential diagnosis of acute abdominal pain in cocaine abusers.
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PMID:Haemoperitoneum associated with cocaine abuse: a case report. 1827 86

Cocaine is a known potent vasoconstrictor known to cause various complications ranging from nasal septum perforations to myocardial ischemia. Many gastrointestinal effects of cocaine are reported, including bowel ischemia and gangrene. The knowledge on endoscopic appearance of cocaine-induced gastric ulcers is limited, mainly due to presentation of patients with frank perforations. We report a case of 48 year old male, a non-smoker but chronic substance abuser, who presented with abdominal pain, mainly epigastric with radiation to the back. Abdominal CT scan was normal, and endoscopy showing a single chronic non-bleeding ulcer at the incisura. The ulcer due to large sized, round in shape with irregular borders and thick eschar appearance is characteristic of cocaine-induced ulcer. It is important for physicians to remain cognisant of gastrointestinal complications of cocaine, recognise these ulcers endoscopically and prevent perforations in these subsets of patients.
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PMID:Atypical gastric ulcer with characteristic eschar appearance. 2093 Aug 94

Cocaine-mediated tissue injury is well established, particularly myocardial ischemia and infarction. Gastrointestinal complications including mesenteric ischemia, ischemic colitis and intestinal perforation occur less frequently. Cocaine-induced visceral arterial thrombosis is a rare finding. We report a case of a 49-year-old chronic cocaine user with superior mesenteric artery (SMA) thrombosis. The patient presented with a 24-h history of abdominal pain, nausea and vomiting. Physical examination documented tachycardia and a soft, non-rigid abdomen with voluntary guarding. Abdominal X-ray did not show any evidence of peritoneal free air or bowel obstruction. Laboratory investigations revealed elevated white blood cells and a high anion gap; a blood gas analysis was not done. Three hours after initial presentation, the patient had a cardiac arrest and died. At autopsy, the jejunum was ischemic, without obvious infarction. The SMA was occluded at its origin by significant atherosclerosis with superimposed thrombus. The myocardium had fibrosis, without acute infarction, and severe triple coronary artery atherosclerosis. Toxicological blood analysis confirmed cocaine use. This report emphasizes the need to consider chronic stimulant drug abuse in accelerated atheroma and thrombosis of visceral arteries.
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PMID:Sudden death from superior mesenteric artery thrombosis in a cocaine user. 2159 Apr 56

Most pheochromocytomas are not suspected clinically while a high percentage of them are curable with surgery. We present the case of an adult cocaine-addicted male patient with an underlying pheochromocytoma and repeated myocardial infarctions. Computed tomography showed a left round adrenal mass, also high 24-hour urine levels of catecholamines and metanephrines were detected from urinalysis. The patient was given alpha and beta blockers, moreover a laparoscopic left adrenalectomy was performed. Cocaine can block the reuptake of noradrenaline, leading to increasing its concentration and consequently its effects as well, and induce local or diffuse coronary vasoconstriction in normal coronary artery segments per se, cocaine can also trigger pheochromocytoma crisis, and therefore, cardiac complications such as myocardial infarction due to these additive effects are intended to occur. For this reason, in the presence of typical clinical manifestations of pheochromocytoma, such as sustained or paroxysmal hypertension, headache, sweating, tachycardia and abdominal pain, probable association of this tumor in patients with cocaine abuse and associated cardiac complications must be ruled out.
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PMID:Acute myocardial infarction secondary to catecholamine release owing to cocaine abuse and pheochromocytoma crisis. 2385 20

Cocaine has been associated with known adverse effects on cardiac, cerebrovascular and pulmonary systems. However, the effect of cocaine on other organs has not been extensively reported. A middle age man presented with abdominal pain and nausea after inhalation of crack cocaine. On admission, he was found to be hypertensive and tachycardic. Physical examination revealed mild abdominal tenderness without rebound. Laboratory investigations were significant for acute kidney failure with elevated serum creatinine (3.72 mg/dL), thrombocytopenia (platelet count 74,000/UL), elevated alanine and aspartate transaminases (ALT 331 U/L; AST 462 U/L) and elevated creatine phosphokinase (CPK 5885 U/L). Urine toxicology screening solely revealed cocaine. A clinical diagnosis of cocaine toxicity was made and patient was admitted to the intensive care unit because of multi organ failure. Despite downward trending of liver enzymes during the hospital course, he continued to have residual renal insufficiency and a low platelet count at the time of discharge. In a patient with history of recent cocaine use presenting with these manifestations, cocaine itself should be considered as a likely cause.
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PMID:Acute renal failure, thrombocytopenia, and elevated liver enzymes after concurrent abuse of alcohol and cocaine. 2476 97

Spontaneous isolated superior mesenteric artery dissection (SISMAD) is a rare potentially fatal disease. We present a case of cocaine-related SISMAD in a patient with abdominal pain. A 38-year-old African American male with hypertension and alcohol, cocaine, and tobacco abuse presented with abdominal pain and recent cocaine use. A CT angiogram revealed SISMAD; he was treated with conservative management. Cocaine and SISMAD share similar pathophysiologic mechanisms pertaining to vascular smooth muscle cell apoptosis and increased shear stress at fixed vascular positions. Our report emphasizes the need to consider cocaine abuse in SISMAD pathophysiology, risk stratification, and treatment algorithms in future studies.
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PMID:A Spontaneous Isolated Superior Mesenteric Artery Dissection Associated with Cocaine Abuse: A Pathomechanistic Association. 3256 53