Can Heroin Poisoning Lead To Stomach Necrosis? A Case Report

Opiate (including heroin) use prevalence is 1.2% of the world population according to the last report of UNOCD. In Iran about 2 million people of population are drug abusers..Heroin reduces gastric motility and prolongs gastric emptying time and it can cause gastric dilation which can be a reason for gastric ischemia . Gastric ischemia is an uncommon condition do to the rich gastric blood perfusion and collateral arteries . As some of studies show, gastric dilation can be a cause for gastric necrosis.

A 22-year-old woman who presented to our hospital with severe abdominal pain and several episodes of vomiting. The patient declared that she had a history of addiction to methamphetamine and heroin. In abdominal examination, a soft and non-distended abdomen with generalized tenderness, mostly in hypogastric region without rebound tenderness was revealed.Abdominal radiograph revealed a much distended stomach. A non-contrast CT abdomen confirmed severe gastric dilatation. On endoscopy, multiple necrotic lesions were seen throughout the stomach and mostly in the proximal part. Our finding in the laparotomy was gastric necrosis in the proximal part, which resulted in a total gastrectomy. esophagojejunostomy with roux en y reconstruction was done after total gastrectomy.

Opioids can increase the risk of GI dysfunction and they can increase risk of infection in GI tract. In our case ,abuse of heroin caused a gastric dilation and massive gastric necrosis.