To the Editor.—
Numerous cocaine complications have been described since "crack" appeared on the streets of our largest cities.1 Over the last 18 months we have operated on several young men with perforated gastric ulcers in our large municipal hospital that serves a poor black population. Among a total of 23 patients with perforated ulcers, 5 were young male crack users (ages, 27 to 38 years) without a history of gastric symptoms who had perforated gastric ulcers (two of which were pyloric) related to smoking crack. Compared with age-matched, non—crack-using "control" patients operated on during the same period, the crack users had a shorter duration of symptoms (1 to 5 days vs >30 days), lower leukocyte counts (3.4×109/L to 9.7×109/L vs 12.2×109/L to 14.0×109/L), and a shorter length of stay (7.6 vs 9.5 days).The location of the perforation (gastric rather
Abramson DL, Kral JG, Gertler JP, Lewis T. Gastropyloric Ulcers Related to 'Crack'. JAMA. 1989;262(5):617–618. doi:10.1001/jama.1989.03430050027019
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