Acta Medica Iranica 2017. 55(5):344-347.

Fatal Small Intestinal Ischemia Due to Methamphetamine Intoxication: Report of a Case With Autopsy Results
Hamid Attaran

Abstract


Methamphetamine is one of the most common abused drugs, so its various effects on different body organs should be familiar to all physicians. Regarding its gastrointestinal sequels, there are few reports of ischemic colitis induced by its vasoconstrictive effects. This is the first report of isolated small intestinal infarction resulting in death following methamphetamine toxicity. A 40-year-old woman with a past history of medical treatment for obesity referred to hospital with severe chest and back pain, perspiration, nausea, agitation, high blood pressure, bradycardia and subsequent lethargy and vasomotor instability. Cardiac evaluations were normal, and a toxicologic urinalysis revealed methamphetamine. Later, abdominal pain predominated, and ultrasonography revealed signs of bowel infarction. She did not consent to surgery and succumbed afterward. At autopsy gangrene and perforation of distal ileum were found. The cause of death was determined as intestinal gangrene following methamphetamine toxicity. Methamphetamine has anorectic effects and so is used in some "diet pills"; Consumers may not even know they are using methamphetamine. Hence in cases of either known MA abuse or those using unknown weight reduction drugs presenting with gastrointestinal complaints or abdominal pain, intestinal ischemia should be kept in mind and if plausible, intervened promptly.


Keywords


Methamphetamine; Intestinal ischemia; Drug abuse; Diet pills

Full Text:

PDF

References


-Radfar SR, Rawson RA. Current Research on Methamphetamine: Epidemiology, Medical and

Psychiatric Effects, Treatment, and Harm Reduction Efforts. Addict Health 2014; 6(3-4): 146-54.

-Barceloux, Donald G. Medical Toxicology of Drug Abuse Synthesized Chemicals and Psychoactive Plants. N.J: John Wiley & Sons; 2012: 3-56.

-Goldfrank, Lewis R. Goldfrank's Toxicological Emergencies. New York: McGraw-Hill Medical; 2011: 1078-1090.

- Brannan TA, Soundararajan S, Houghton BL. Methamphetamine associated shock with intestinal infarction. MedGenMed 2004; 6: 6.

- Khaheshi, Isa, Mohammad Parsa Mahjoob, Shooka Esmaeeli, Vahid Eslami, and Habib Haybar. Simultaneous Thrombosis of the Left Anterior Descending Artery and the Right Coronary Artery in a 34-Year-Old Crystal Methamphetamine Abuser. Korean Circulation Journal Korean Circ J 2015; 45: 158-60.

- Cyrus Parsa, Robert Orlando, Ira Felman, David A Duarte, Bradley Jacoby. Multiple-organ failure due to abuse of methamphetamine - A case of Methamphetamine-associated intestinal infarction presenting with altered mental status, abdominal pain, and laboratory findings reminiscent of diabetic ketoacidosis. The Journal of Southern California Clinicians 2012; 6: 25-28.

-Holubar, Stefan D. Methamphetamine Colitis. Arch Surg Archives of Surgery 2009; 144: 780.

-Johnson, Timothy D., and Malcolm M. Berenson. Methamphetamine-Induced Ischemic Colitis. Journal of Clinical Gastroenterology 1991; 13: 687-89.

-Herr, Robert D., and E.martin Caravati. Acute Transient Ischemic Colitis after Oral Methamphetamine Ingestion. The American Journal of Emergency Medicine 1991; 9: 406-09.

-Prendergast Christina, DO, Aladdin H. Hassanein, MD, Vishal Bansal, MD, and Leslie Kobayashi, MD. Shock with Intestinal Ischemia: A Rare Complication of Methamphetamine Use. The American surgeon 2014; 80: 101-102.

- D.B. Diercks, E. Boghos, S. Offerman, A. Lee, J.E. Weber. Presenting Emergency Department Complaints in Patients with Acute Methamphetamine and Cocaine Use. Annals of Emergency Medicine 2005; 46, Supplement: 51


Refbacks

  • There are currently no refbacks.


Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.