, Volume 42, Issue 7, pp 1537-1541

Spectrum of Ischemic Colitis in Cocaine Users

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Ischemic enterocolitis is a well-recognizedentity occurring in cocaine users. Diagnosis is based onthe presence of rectal bleeding, abdominal pain, ahistory of cocaine use, supportive endoscopic and histopathologic findings, and the absence ofother etiologic mechanisms of ischemic colitis. In thisstudy, we evaluated endoscopic and histopathologicfindings in seven patients with cocaine colitis. Lesions seen by endoscopy, which were restricted to theleft colon, included hemorrhagic edematous mucosa,pseudopolyps, and ulcerations. Rectal involvement, nota common feature of ischemic colitis, was seen in five patients. In two patients histologiclesions were classified acute/subacute, and in threepatients as subacute/chronic. In the remaining twopatients lesions were combined acute/subacute andchronic. The presence of subacute/chronic lesionssuggested recurrent ischemic episodes and could reflectrepeated use of cocaine. Future studies will be neededto define the long-term clinical and histopathologic significance of these subacute/chroniclesions.