Question: Gastrointestinal pathology, including bowel ischemia and GI perforation, has been described in association with cocaine and/or crack cocaine use. What is the anatomic site of most cocaine related GI perforations?
Answer: The cited references note “Most of the intestinal perforations seem to occur juxtapyloric or within the first part of the duodenum.” (Lee HS et al. Acute gastroduodenal perforations associated with use of crack. 1990 Ann Surg 211:15-17 and Muniz AE and Evans T. Acute manifestations associated with use of crack. 2001 Am J Emerg Med 19(1):61-63)