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Acute abdomen in drug abusers


Authors: L. Hána;  M. Ryska
Authors place of work: Surgical Clinic of 2nd Faculty of Medicine of the Charles University and the Military University Hospital Prague
Published in the journal: Rozhl. Chir., 2019, roč. 98, č. 1, s. 14-17.
Category: Original articles

Summary

Introduction:

Acute abdomen is one of the most important issues in abdominal surgery. Our study aims to describe the differences in clinical presentation of patients, in the course of their hospitalization, and in morbidity and mortality of patients with drug abuse; another aim is to describe our own experience with drug abusers with acute abdomen.

Method:

Patients with the history of drug abuse and with non-traumatic acute abdomen were included retrospectively to our set. We chose patients hospitalized between 2013 and 2018. We analyzed the demographical data of the patients, types of abused drugs, concordance between the first and final diagnosis, findings of paraclinical examinations, the need of surgical treatment, and the type of surgery. Morbidity, mortality and the length of hospital stay were tracked. All the data was evaluated using descriptive statistics.

Results:

8 patients (4.7 per mille of all the patients hospitalized for acute abdomen) fulfilled the criteria of our study. All the patients were men with median age 32 years. Pervitin (methamphetamine) was the most frequently abused drug (in 50%), followed by heroin, benzodiazepines, tetrahydrocannabinol, subutex, hypnotics and tramadol. Peptic ulcer perforation was the most frequent diagnosis in our set (in 50% of all patients). The other diagnoses included: two cases of upper gastrointestinal tract bleeding, one case of Crohn’s disease relapse with peritonitis and one case of colitis of the ascending colon. Surgical treatment was necessary in 75% patients. 30-day mortality was zero; an early complication (wound dehiscence) developed in one operated patient. Mean length of hospital stay was 9.7 days in our set, with the median of 7 days.

Conclusion:

Drug abusers represent only a marginal part of all patients with acute abdomen. This group is characterized by a significantly lower age, by a considerable predominance of men and by the preference of perforated peptic ulcer.

Key words:

acute abdomen, gastric and duodenal peptic ulcer perforation, drug abuse


Zdroje
  1. Ferko A, Šubrt Z, Dědek T. Chirurgie v kostce, Praha, Grada Publishing 2015.

  2. Mezinárodní statistická klasifikace nemocí a přidružených zdravotních problémů: MKN-10: desátá revize. Praha, Bonton Agency 2008.

  3. Brown CD, Maxwell F, French P, et al. Stercoral perforation of the colon in a heroin addict. BMJ Case Rep 2017.

  4. Yahchouchy E, Debet A, Fingerhut A. Crack cocaine-related prepyloric perforation treated laparoscopically. Surg Endosc 2002;16:220.

  5. Aspirin/paracetamol/caffeine abuse: Duo-­denal ulcer and its complications: 3 case reports. Reactions weekly 2018;1693:68.

  6. Ippolito SF, Spitz WU. Gastrointestinal hemorrhage from an internal jugular abscess in an intravenous drug addict. Am J Forensic Med Pathol 1990;11:158−9.

  7. Albu E, Parikh V, Abugaida AM, et al. Delayed splenic rupture in a drug addict. Ann Emerg Med 1993;22:861−2.

  8. Kahrom M, Kahrom H. Perforation of peptic ulcer following abrupt cessation of long-term opiate use. Surg Today 2010;40:836−9.

  9. Hájek M, Charvátová E, Křepelka P, et al. Náhlé příhody břišní. Praha, Centrum doporučených postupů pro praktické lékaře 2011.

  10. Cervellin G, Mora R, Ticinesi A, et al. Epi­demiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases. Ann Transl Med 2016;4:36.

  11. Ferris M, Quan S, Kaplan BS, et al. The global incidence of appendicitis: A systematic review of population-based studies. Ann Surg 2017;266:237−41.

  12. Agaba EA, Klair T, Ikedilo O, et al. A 10-year review of surgical management of complicated peptic ulcer disease from a single center: Is laparoscopic approach the future? Surg Laparosc Endosc Percutan Tech 2016;26:385−90.

  13. Feliciano DV, Ojukwu JC, Rozycki GS, et al. The epidemic of cocaine-related juxtapyloric perforations: with a comment of testing for Helicobacter pylori. Ann Surg 1999;229:801−4.

  14. Věkové složení obyvatelstva hl. m. Prahy v roce 2011 [on line]. Český statistický úřad 2012. Available fom: https://www.czso.cz/documents/10180/20567029/104003_12.pdf/b4d8a4ce-e779-4a2f-afb7-50d24ae4ce0b.

  15. Výroční zpráva o drogách: Češi ve velkém konzumují alkohol a tabák, počet uživatelů nelegálních drog klesá [on line]. Vláda České republiky, 2016. Available from: https://www.vlada.cz/cz/ppov/protidrogova-politika/media/vyrocni-zprava-o-drogach-cesi-ve-velkem-konzumuji-alkohol-a-tabak--pocet-uzivatelu-nelegalnich-drog-klesa--151149/.

  16. Menclová K, Traboulsi E, Nikov A, et al. Treatment of acute appendicitis: Retrospective analysis. Rozhl Chir 2016;95:317−21.

  17. Søreide K, Thorsen K, Søreide JA. Stra­tegies to improve the outcome of emergency surgery for perforated peptic ulcer. Br J Surg 2014;101:e51−64.

  18. Thorsen K, Glomsaker TB, von Meer A, et al. Trends in diagnosis and surgical management of patients with perforated peptic ulcer. J Gastrointest Surg 2011;15:1329−35.

  19. Kuzmich S, Harvey CJ, Fascia DT, et al. Perforated pyloroduodenal peptic ulcer and sonography. AJR Am J Roentgenol 2012;199:W587−94.

  20. Vărcuş F, Beuran M, Lica I, et al. Laparoscopic repair for perforated peptic ulcer: A retrospective study. World J Surg 2017;41:948−953.

  21. Kim MG. Laparoscopic surgery for perforated duodenal ulcer disease: Analysis of 70 consecutive cases from a single surgeon. Surg Laparosc Endosc Percutan Tech 2015;25:331−6.

  22. Yang YJ, Bang CS, Shin SP, et al. Clinical characteristics of peptic ulcer perforation in Korea. World J Gastroenterol 2017;23:2566−74.

  23. Wilhelmsen M, Møller MH, Rosenstock S. Surgical complications after open and laparoscopic surgery for perforated peptic ulcer in a nationwide cohort. Br J Surg 2015;102:382−7.

Štítky
Surgery Orthopaedics Trauma surgery
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