Mesenteric ischemia after massive cannabis and cocaine use in a young subject

Cannabis and cocaine use cause marked vasoconstriction, which can lead to a variety of systemic complications, particularly gastrointestinal. Among these, mesenteric ischemia is particularly difficult to diagnose, and can have serious consequences if not treated promptly. We report the case of a 19-year-old man presenting with mesenteric ischemia related to chronic cocaine and cannabis use. The diagnosis was established by computed tomography (CT). He required emergency surgery with segmental resection of the necrotic small intestine and placement of an ileostomy. The literature on cocaine-induced intestinal ischemia reveals great variability in clinical and therapeutic outcomes. Biological tests lack specificity, and are negative in most cases. We suggest that testing for cannabis and cocaine should be carried out systematically in all young patients admitted for a vascular accident, regardless of location.