heroin and Peptic-Ulcer-Perforation

Since the 1980s the abuse of cocaine has been -associated with gastroduodenal perforations in the United States. Here, we report the case of a 28-year-old man who came to our hospital with severe abdominal pain after smoking cocaine. Physical examination revealed generalised abdominal guarding. His X-ray did not show any free intraperitoneal air. However, there was a slightly elevated white blood cell count. Upon laparoscopic exploration of the abdomen, the -patient was found to have a generalised peritonitis secondary to a perforation of the prepyloric anterior wall. The operative procedure consisted of ulcer excision and primary closure with a pyloroplasty as well as an extensive abdominal irrigation after laparotomy.

Topics: Abdomen, Acute; Adult; Cocaine; Cocaine-Related Disorders; Diagnosis, Differential; Heroin; Heroin Dependence; Humans; Laparoscopy; Male; Narcotics; Peptic Ulcer Perforation; Peritonitis; Pylorus; Stomach Ulcer; Vasoconstrictor Agents

Topics: Adult; Anesthesia, General; Asphyxia; Barbiturates; Brain; Brain Diseases; Female; Forensic Medicine; Globus Pallidus; Heart Arrest; Heroin; Humans; Hypoxia, Brain; Injections, Intravenous; Male; Middle Aged; Morphine Dependence; Necrosis; Peptic Ulcer Perforation; Suicide