Background: An 18-year-old adolescent with cystic fibrosis developed massive gastrointestinal bleeding.

Methods: History, physical examination, upper and lower endoscopy and wireless capsule endoscopy were performed.

Results: Upper and lower endoscopy did not reveal cause of persistent bleeding. Wireless capsule endoscopy revealed pan-gastrointestinal ischemic injury. Further discussion with the patient revealed recent cocaine ingestion.

Conclusion: Most reported cases of gut injury following cocaine abuse describe juxtapyloric and colonic injury; this case demonstrates that ischemic gut injury after cocaine use can be extensive and may be the reason for the associated high mortality.

Key words: cocaine abuse; gastrointestinal bleeding; wireless capsule endoscopy

World J Pediatr 2009;5(2):149-151