Cocaine-Induced Chronic Bowel Ischemia Manifesting As Small Bowel Obstruction.

Cocaine represents one of the most frequently used recreational drugs worldwide. Cocaine-related disorders mostly affect the nervous and cardiovascular system, although gastrointestinal complications are not negligible and sometimes life-threatening. The most common gastrointestinal manifestations of cocaine abuse are ulceration, infarction, perforation, ischemic enterocolitis, and rarely hemorrhage, with mesenteric ischemia being the underlying pathophysiological mechanism. Herein, we report a rare case of cocaine-induced small bowel obstruction in a young female patient, caused by chronic mesenteric ischemia and excessive intestinal wall fibrosis.

Postoperative Bowel Obstruction as a Rare Complication of an Abdominal Drain.

Although routine intra-abdominal drain insertion following surgery represents a common practice worldwide, its utility has been questioned during the last decades. Several comparative studies have failed to document significant benefits from routine draining, and drain insertion has been correlated with various complications as well. Drain-related complications include, but are not limited, to infection, bleeding, and tissue erosion. Herein, we present the case of a 32-year-old patient with perforated peptic ulcer and purulent peritonitis, whose postoperative course was complicated by early mechanical bowel obstruction due to an abdominal drain. A high level of clinical suspicion, along with accurate imaging diagnosis, dictated prompt removal of the drain, which resulted in immediate resolution of the patient's symptoms. We aim to increase the clinical awareness of this rare complication related to intra-abdominal drain utilization with this report.