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St. Josefs Hospital Dortmund-Süd, Abteilung für Allgemein-, Viszeral- und Unfallchirurgie, Darmzentrum Ruhr, Dortmund, Deutschland. andrej.ring@ruhr-unibochum.de
Since the 1980s the abuse of cocaine has been -associated with gastroduodenal perforations in the United States. Here, we report the case of a 28-year-old man who came to our hospital with severe abdominal pain after smoking cocaine. Physical examination revealed generalised abdominal guarding. His X-ray did not show any free intraperitoneal air. However, there was a slightly elevated white blood cell count. Upon laparoscopic exploration of the abdomen, the -patient was found to have a generalised peritonitis secondary to a perforation of the prepyloric anterior wall. The operative procedure consisted of ulcer excision and primary closure with a pyloroplasty as well as an extensive abdominal irrigation after laparotomy.
Georg Thieme Verlag Stuttgart, New York.
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