SHM Converge Scientific Abstract ePoster Gallery-Intussusception Resulting From Uncontrolled Severe Opioid-Induced Constipation and Chronic Cocaine Use

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This case report describes a rare episode of adult colonic intussusception in a 56-year-old man with daily cocaine and intranasal heroin use, severe constipation, and abdominal pain. Although he was still passing flatus and had a soft abdomen on exam, CT imaging showed telescoping of the proximal ascending colon into the distal ascending colon, suggesting intussusception. Urine toxicology was positive for cocaine and opioids.<br /><br />Because adult intussusception is usually caused by a structural lesion, often a malignancy, the team investigated for an underlying lead point. Diagnostic laparoscopy found extensive omental adhesions in the midline and right lower quadrant but no visible mass or active intussusception. Colonoscopy the next day also showed no mass or colonic abnormality. The patient was discharged on an aggressive bowel regimen.<br /><br />The authors propose that, in this patient, uncontrolled opioid-induced constipation combined with chronic cocaine use may have contributed to the event. Cocaine may reduce gastrointestinal blood flow through vasoconstriction, potentially causing decreased peristalsis and ischemia. Since no definite mechanical cause was identified, reduced colonic motility and possible focal ischemia are suggested as likely mechanisms.<br /><br />The report emphasizes that this may be the first documented case linking intussusception to chronic cocaine and opioid use, highlighting a possible rare complication of polysubstance abuse.

Asset Subtitle

Sera Satoi

Meta Tag

Author List Carl Dickler, Erica Park, Michael Smith, Priya Simoes, Sera Satoi, Shanique Wilson

Category Clinical Vignettes

Concept Colonic Intussusception

Concept Structural Lesion

Concept Malignancy

Concept CT Imaging

Concept Chronic Opioid Use

Distinguished Non-Finalist

Presenter Organization Mount Sinai Beth Israel

Presenting Author Sera Satoi

Track Adult

Keywords

adult colonic intussusception

cocaine use

opioid-induced constipation

intranasal heroin

abdominal pain

CT imaging

telescoping colon

diagnostic laparoscopy

colonoscopy

polysubstance abuse

Colonic Intussusception

Structural Lesion

Malignancy

CT Imaging

Chronic Opioid Use