Cocaine-induced mesenteric ischemia: treatment with intra-arterial papaverine

Herskowitz, Michael M.; Gillego, Virgilio; Ward, Marie; Wright, G V

doi:10.1007/s10140-002-0218-7

Cited by 16 publications

(3 citation statements)

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“…In addition, there were 45 case reports among the included articles. 2 - 4 , 8 - 49 In addition to case reports, there were case series. 1 , 50 - 56 In the final step, manuscripts where the route of cocaine consumption was missing were excluded.…”

Section: Resultsmentioning

confidence: 99%

Does the Route of Cocaine Use Affect the Mortality and Outcomes of Cocaine-Induced Intestinal Ischemia? A Systematic Review

Farooq

Gondal

Susheela

et al. 2021

Journal of Investigative Medicine High Impact Case Reports

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Intestinal ischemia results from diminished perfusion of the colon resulting in tissue hypoxia. Anecdotal reports suggest that cocaine-induced intestinal ischemia has the highest mortality and longer length of stay among the vasoconstrictors. The present study aimed to summarize the available studies in the literature to assess the effect of routes of consumption on the outcomes of cocaine-induced intestinal ischemia. We conducted a systematic search of MEDLINE from inception through October 2019. Studies of cocaine-induced intestinal ischemia were included if data were available on comorbidities, mortality, and hospital length of stay (LOS). The study’s primary outcomes were mortality and need for surgery, while secondary outcomes included the hospital length of stay, LACE index, and hospital score. Statistical tests used included linear and binary logistic regression. STATA 2015 was used, and P < 0.05 was statistically significant. Of the 304 studies, 8 case series and 45 case reports (n = 69 patients) met the inclusion criteria. Different routes of cocaine use had similar mortality odds and the need for surgery for intestinal ischemia. Hospital LOS showed significant difference among the subgroups. Readmission scores (LACE and hospital score) were higher for intravenous and smoking than ingestion and intranasal use ( P < 0.05). In conclusion, different routes of cocaine use appear to have similar mortality odds for intestinal ischemia, which vary significantly among the different routes of cocaine consumption for the length of stay and readmission scores. Prompt recognition of the route of cocaine use is vital to improve the outcome. Large-scale and well-designed observational studies are needed to investigate this topic further.

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Section: Resultsmentioning

confidence: 99%

Does the Route of Cocaine Use Affect the Mortality and Outcomes of Cocaine-Induced Intestinal Ischemia? A Systematic Review

Farooq

Gondal

Susheela

et al. 2021

Journal of Investigative Medicine High Impact Case Reports

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“…This patient developed similar complications, and it is likely that NOMI, as a comorbid condition to the AEN, was a significant contributor to his death. If NOMI is suspected and confirmed early, it can sometimes be treated effectively with intravenous vasodilators (eg, papaverine or prostaglandin E 1 ) 14 15…”

Section: Discussionmentioning

confidence: 99%

Acute oesophageal necrosis in a young man with cocaine and alcohol abuse

Pineo

2016

BMJ Case Reports

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We report a case of acute oesophageal necrosis (AEN) and non-occlusive mesenteric ischaemia in an otherwise healthy 30-year-old man with cocaine and alcohol abuse. Although cocaine might be expected more frequently to cause oesophageal necrosis through sympathomimetic vasoconstriction, this is only the second known case report of AEN in a patient with cocaine abuse. His symptoms at presentation included epigastric abdominal pain, haematemesis and generalised weakness. He developed moderate neutropenia and severe lactic acidosis. Treatment consisted of intravenous proton-pump inhibitors, granulocyte colony stimulating factor, broad-spectrum antibiotics and ultimately exploratory laparotomy after his condition worsened. He died within 24 hours of presentation from a combination of systemic inflammatory response syndrome, acute respiratory distress syndrome and disseminated intravascular coagulation. AEN was discovered postmortem. We conclude that AEN should be suspected in any patient with haematemesis and substance abuse, and discovery of AEN should prompt a thorough evaluation for potentially lethal comorbid conditions.

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“…2. There is no positive control group included in the study, since other vasodilators, like papaverine, are preferred in the treatment of ischemic colitis [2]. 3.…”

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confidence: 99%