Massive Portal Venous Air and Pneumatosis Intestinalis Associated with Cocaine-Induced Mesenteric Ischemia

Massive Portal Venous Air and Pneumatosis Intestinalis Associated with Cocaine-Induced Mesenteric Ischemia

Background We report a 53-year-old female who presented to the emergency department in distress with an acute abdomen after recreational use of cocaine. Discussion The patient’s computed tomography scan revealed extensive portal venous air with small-bowel pneumatosis intestinalis resulting from int...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery Vol. 16; no. 1; pp. 223 - 225
Main Authors: Rittenhouse, David W., Chojnacki, Karen A.
Format: Journal Article
Language:English
Published: New York Springer-Verlag 2012
Springer Nature B.V
Subjects:
Abdomen
Adrenergic receptors
Case reports
Cocaine
Cocaine-Related Disorders - complications
Drug use
Embolism, Air - etiology
Emergency medical care
Female
Gastroenterology
GI Image
Humans
Ileum - blood supply
Ileum - surgery
Ischemia
Ischemia - diagnostic imaging
Ischemia - etiology
Ischemia - surgery
Jejunum - blood supply
Jejunum - surgery
Medicine
Medicine & Public Health
Mesenteric Vascular Occlusion - etiology
Mesenteric Veins
Middle Aged
Patients
Pneumatosis Cystoides Intestinalis - diagnostic imaging
Pneumatosis Cystoides Intestinalis - etiology
Pneumatosis Cystoides Intestinalis - surgery
Portal Vein
Radiography
Small intestine
Surgery
Tomography
Veins & arteries
United States > US
Portal venous air
Cocaine
Mesenteric ischemia
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Summary:Background We report a 53-year-old female who presented to the emergency department in distress with an acute abdomen after recreational use of cocaine. Discussion The patient’s computed tomography scan revealed extensive portal venous air with small-bowel pneumatosis intestinalis resulting from intestinal ischemia. Air could be seen throughout the superior mesenteric vein, portal vein, and hepatic portal venous distribution. The patient underwent extensive resuscitation and resection of small bowel requiring three operative interventions. A pertinent review of the literature of cocaine-induced small-bowel ischemia is provided covering the pathophysiology, clinical findings, and epidemiology. Conclusion Cocaine-induced mesenteric ischemia is a serious disease causing significant morbidity and mortality. Operative therapy is often required.
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-011-1579-6