{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:38:46Z","timestamp":1788910726092,"version":"build-2803163510"},"reference-count":11,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,1,20]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>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\u00d71 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.<\/jats:p>","DOI":"10.1136\/bcr-2020-239981","type":"journal-article","created":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T11:41:11Z","timestamp":1612957271000},"page":"e239981","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Rare cause of acute abdomen\u2013cocaine-induced small intestinal perforation with coexisting lower gastrointestinal bleed: an unusual presentation"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1790-9558","authenticated-orcid":false,"given":"Sriram","family":"Deivasigamani","sequence":"first","affiliation":[{"name":"General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santhosh","family":"Irrinki","sequence":"additional","affiliation":[{"name":"General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimil","family":"Shah","sequence":"additional","affiliation":[{"name":"Medicine, Seth GS Medical College and KEM Hospital, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1095-7810","authenticated-orcid":false,"given":"Yashwant","family":"Sakaray","sequence":"additional","affiliation":[{"name":"General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,2,10]]},"reference":[{"key":"2025082708371432000_14.2.e239981.1","doi-asserted-by":"publisher","DOI":"10.1258\/jrsm.99.2.51"},{"key":"2025082708371432000_14.2.e239981.2","doi-asserted-by":"crossref","first-page":"189","DOI":"10.4103\/0019-5545.69232","article-title":"Substance use and addiction research in India","volume":"52","author":"Murthy","year":"2010","journal-title":"Indian J Psychiatry"},{"key":"2025082708371432000_14.2.e239981.3","doi-asserted-by":"crossref","DOI":"10.14309\/crj.0000000000000041","article-title":"Cocaine gut.","volume":"6","author":"Bansal","year":"2019","journal-title":"ACG Case Rep J"},{"key":"2025082708371432000_14.2.e239981.4","article-title":"Small intestinal ischemia with pneumatosis in a young adult: what could be the cause?","volume":"2013","author":"Nidimusili","year":"2013","journal-title":"Case Rep Gastrointest Med"},{"key":"2025082708371432000_14.2.e239981.5","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-7-38"},{"key":"2025082708371432000_14.2.e239981.6","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1097\/00007611-200009000-00015","article-title":"Cocaine-associated ischemic colitis","volume":"93","author":"Linder","year":"2000","journal-title":"South Med J"},{"key":"2025082708371432000_14.2.e239981.7","first-page":"624","article-title":"Direct effects of vasoactive agents on segmental resistance of the mesenteric and portal circulation. 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