Illicit Drug, Ischemic Bowel

In the young adult or middle-aged patient with abdominal pain and bloody diarrhea, a history of cocaine abuse is an important consideration in the differential diagnosis. Ischemic colitis is the most frequently seen form of mesenteric ischemia, which is more common in elderly patients but also is seen in younger patients. Its causes can be broadly divided into occlusive and nonocclusive entities. Treatment options for colonic ischemia associated with cocaine use are limited and usually conservative. Shaheen et al discuss the assessment, diagnosis, and management of a 44-year-old male construction worker presented with 1 year of recurrent, sharp, left-sided abdominal pain associated with frequent loose stools.