Abdominal complications from crack cocaine.

Not only is cocaine a powerfully addictive and dangerous drug of abuse, the use of the purified cocaine derivative crack has also reached epidemic proportions. Apart from causing fatal cardiorespiratory complications, crack cocaine is capable of producing surgical emergencies, which may or may not be associated with the pharmacology of cocaine itself. This is a report of crack-induced pneumoperitoneum, the mechanism of which seemed to be related to the prolonged Valsalva manoeuvre during crack smoking. Other differential diagnoses of crack related pneumoperitoneum are also discussed.