Rare cause of acute abdomen–cocaine-induced small intestinal perforation with coexisting lower gastrointestinal bleed: an unusual presentation

2021 ◽  
Vol 14 (2) ◽  
pp. e239981
Author(s):  
Sriram Deivasigamani ◽  
Santhosh Irrinki ◽  
Jimil Shah ◽  
Yashwant Sakaray
Keyword(s):  
Cocaine Abuse ◽  
Lower Gastrointestinal Bleeding ◽  
Recreational Drug ◽  
Intestinal Segment ◽  
Gastrointestinal Complications ◽  
Lower Gastrointestinal Bleed ◽  
Small Intestinal ◽  
Addictive Drug ◽  
Bowel Mucosa

Cocaine, an alkaloid, is an addictive drug and its abuse as a recreational drug is on the increasing side with its associated complications. Gastrointestinal complications, after cocaine abuse, are less known and need to be addressed since the abuse is on the rise and the existing evidence is scarce. We report a case of a 22-year-old male patient who presented with abdominal pain following a cocaine injection. On examination, signs of peritonitis were noted and laparotomy revealed a 2×1 cm perforation in the distal ileum. The unhealthy intestinal segment was resected and taken out as a double-barrel ileostomy. The patient had an episode of severe lower gastrointestinal bleeding on postoperative day 6. CT and colonoscopy revealed signs of ischaemic bowel and tissue biopsy showed oedematous, inflamed and haemorrhagic bowel mucosa. The patient was managed conservatively and is doing well under follow-up in a de-addiction centre.

scholarly journals Internuclear Ophthalmoplegia Secondary to Cocaine Abuse

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Richard L. Rabin ◽  
Azeem Wasay ◽  
Nicolas Biro ◽  
Marcelle Morcos
Keyword(s):  
Cocaine Abuse ◽  
Diffusion Weighted Imaging ◽  
Recreational Drug ◽  
Internuclear Ophthalmoplegia ◽  
Rehabilitation Facility ◽  
Recreational Drug Use ◽  
Lost To Follow Up ◽  
The Brain ◽  
And Diffusion

Purpose. To report a case of internuclear ophthalmoplegia (INO) caused by cocaine. Method. We report a case of a 54-year-old female who presented with a left INO three days after snorting cocaine, and we review the literature. Results. MRI of the brain demonstrated several small abnormal foci in the pons on FLAIR and diffusion weighted imaging consistent with ischemic infarction. The patient’s symptoms remained stable throughout her hospitalization. She was sent to a rehabilitation facility and was lost to follow-up. Conclusion. In cases of extraocular movement abnormalities, it is important to inquire about recreational drug use.

scholarly journals Evolution of the Mesenteric Mass in Small Intestinal Neuroendocrine Tumours

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 443
Author(s):  
Anela Blažević ◽  
Tessa Brabander ◽  
Wouter T. Zandee ◽  
Johannes Hofland ◽  
Gaston J. H. Franssen ◽  
...  
Keyword(s):  
Neuroendocrine Tumours ◽  
Peptide Receptor Radionuclide Therapy ◽  
Size Reduction ◽  
Static Behavior ◽  
Recist 1.1 ◽  
Mesenteric Mass ◽  
Small Intestinal ◽  
Objective Size ◽  
Over Time

Background: A metastatic mesenteric mass is a hallmark of small intestinal neuroendocrine tumours (SI-NETs). However, little is known on its development over time. Therefore, we conducted a study to assess the evolution of a SI-NET-associated mesenteric mass over time. Methods: Retrospectively, 530 patients with proven SI-NET were included. The presence and growth of a mesenteric mass was assessed using RECIST 1.1 criteria on every consecutive CT-scan until the end of follow-up or resection. Results: At baseline, a mesenteric mass was present in 64% of the patients, of whom 13.5% showed growth of the mesenteric mass with a median time to growth of 40 months. Male gender was the only independent predictor of growth (OR 2.67). Of the patients without a mesenteric mass at the first evaluation, 2.6% developed a pathological mesenteric mass. Treatment with peptide receptor radionuclide therapy (PRRT; N = 132) resulted in an objective size reduction of the mesenteric mass in 3.8%. Conclusion: The metastatic mesenteric mass in SI-NETs has a static behavior over time. Therefore, site-specific growth behavior should be taken into account when selecting target lesions and assessing disease progression and therapeutic response. PRRT appears not to be effective for size reduction of the mesenteric mass.

Development of a portocaval shunt using a small intestinal segment in rats

Microsurgery ◽  
2010 ◽  
Vol 30 (4) ◽  
pp. 302-306 ◽  
Author(s):  
Toshiyuki Hata ◽  
Junji Iwasaki ◽  
Shuji Hishikawa ◽  
Yasuhiro Fujimoto ◽  
Shinji Uemoto ◽  
...  
Keyword(s):  
Portocaval Shunt ◽  
Intestinal Segment ◽  
Small Intestinal

Safety and efficacy of the porcine small intestinal submucosa dural substitute: results of a prospective multicenter study and literature review

2007 ◽  
Vol 106 (6) ◽  
pp. 1028-1033 ◽  
Author(s):  
Ghassan K. Bejjani ◽  
Joseph Zabramski ◽  
_ _
Keyword(s):  
Wound Infection ◽  
Small Intestinal Submucosa ◽  
Csf Leak ◽  
Dural Repair ◽  
Dural Substitute ◽  
Csf Leakage ◽  
Porcine Small Intestinal Submucosa ◽  
Small Intestinal ◽  
Intestinal Submucosa

Object Dural substitutes are often needed after neurosurgical procedures to expand or replace dura mater resected during surgery. A new dural repair material derived from porcine small intestinal submucosa (SIS) was evaluated in a prospective multicenter clinical study. Methods Between 2000 and 2003, 59 patients at five different institutions underwent dural reconstruction with the SIS dural substitute, with a minimum follow up of 6 months. The primary goals of the study were to assess the efficacy and safety of the SIS dural substitute according to the rate of cerebrospinal fluid (CSF) leakage, infection, and meningitis. Chiari malformation Type I decompression (32 patients) and tumor resection (18 patients) were the most common procedures performed, with 81% of SIS grafts implanted in the posterior fossa or spine. There was one case of a CSF leak (1.7%), two cases of wound infection (3.4%), and no cases of bacterial meningitis (0%) in the 58 patients available for follow up. In both cases of wound infection, the SIS graft acted as a barrier to infection and was not removed. Intraoperatively, a watertight seal was achieved in all 59 cases. On follow-up imaging available in 27 patients there was no evidence of any adverse reaction to the graft or of cerebral inflammation. Conclusions The SIS dural substitute demonstrated substantial efficacy in these patients after a mean follow up of 7.3 ± 2.2 months. Rates of infection, CSF leakage, and meningitis were comparable to those reported for other dural substitute materials. A lack of adverse reactions to the graft, favorable safety profile, and clinical efficacy all point to the utility of this material as an alternative for dural repair.

Extent and Duration of Small Intestinal Mucosal Injury in Intractable Diarrhea of Infancy

PEDIATRICS ◽  
1980 ◽  
Vol 66 (5) ◽  
pp. 730-735
Author(s):  
Thomas M. Rossi ◽  
Emanuel Lebenthal ◽  
Kenneth S. Nord ◽  
Rafiqua R. Fazili
Keyword(s):  
Elemental Diet ◽  
Mucosal Injury ◽  
Height Velocity ◽  
Common Finding ◽  
Small Intestinal Mucosa ◽  
Intractable Diarrhea ◽  
Young Infants ◽  
Intestinal Mucosal Injury ◽  
Small Intestinal

Thirty infants with intractable diarrhea of infancy (IDI) underwent small bowel biopsies in order to determine the extent and duration of small intestinal mucosal injury. The onset of the persistent diarrhea occurred prior to 3 months of age and continued for an average of 48 days prior to investigation. In 18 cases, no associated entities were found. Mucosal injury was invariably found in all 30 infants: grade IV injury in 11, grade III in eight, grade II in nine, and grade I atrophy in one. Disaccharidase activities were diminished and corresponded to the degree of atrophy. Lactase activity was diminished to a greater extent than sucrase and maltase. Significant, persistent mucosal injury existed for an average of six months in 16 of the 23 (70%) repeat biopsies. All infants were given an elemental diet (ED). Twelve of the 30 infants required parenteral nutrition (PN). These infants were gradually advanced to an oral elemental diet and maintained on this diet until histologic findings and disaccharidase levels were normal. Eighteen infants were fed and maintained on an elemental diet by mouth from time of admission until normal histologic findings and disaccharidases were found. No mortality occurred during management and follow-up. Twenty-two of the 28 infants in whom follow-up growth data were available excelled in weight and height velocity. The data suggest that prolonged injury to the small intestinal mucosa is a common finding in many cases of intractable diarrhea of infancy. Elemental diets should be started early in the course of protracted diarrhea in young infants, and may need to be continued for several months since histologic and enzymatic changes of the small intestine may persist for extended periods.

scholarly journals Non-communicating small intestinal duplication in a dog: a case report

2017 ◽  
Vol 62 (No. 9) ◽  
pp. 516-521 ◽  
Author(s):  
TS Hwang ◽  
DI Jung ◽  
JH Kim ◽  
SC Yeon ◽  
HC Lee
Keyword(s):  
Physical Examination ◽  
Complete Blood Count ◽  
Postoperative Recovery ◽  
Histopathological Diagnosis ◽  
Intestinal Segment ◽  
Radiographic Images ◽  
Intestinal Duplication ◽  
National University ◽  
Enteric Duplication ◽  
Small Intestinal

Enteric duplication is rare in dogs. Here, we report the rarest form of duplication in which two segments are parallel and share a wall for most of their lengths. A nine-year-old spayed female Yorkshire terrier was referred to the Veterinary Medical Teaching Hospital at Gyeongsang National University due to anorexia and diarrhoea. Physical examination, haematological examination, radiography, and ultrasonography were performed. On physical examination, dry, pale mucous membrane was identified. Moderate anaemia with decreased packed cell volume was detected in complete blood count. Serum urea nitrogen and creatinine levels were mildly increased. Radiographic images revealed no significant findings. On ultrasonographic examination, a multi-layered appearance of a focal small intestinal segment was identified in the left mid abdomen. Following the lesion, it was divided into two small intestinal segments. Based on imaging findings, intussusceptions or enteric duplication were suspected. To resect the abnormal small intestinal segment, enterectomy was performed. Follow-up was not performed because the patient expired during the postoperative recovery time. The histopathological diagnosis was non-communicating small intestinal duplication. Non-communicating intestinal duplication is related to embryologic abnormalities and is usually concurrent with other anomalies such as vertebral malformations and urogenital duplications. However, this case had no other anomalies associated with the malformation of the intestine.

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