Letter to the Editor
Cannabinoid hyperemesis syndrome: A case report

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Case report

We present the case of a 16-year-old Hispanic girl who presented with acute epigastric pain and recurrent vomiting for two days duration and was admitted to the pediatric inpatient unit. Patient denied constipation, recent changes in diet, travel, and sick contacts. Urine toxicology was positive for cannabinoids and opiates (opiates given for pain management in the ER). Abdominal ultrasound did not show appendix, gallbladder, or pancreatic pathology, right incidental ovarian cyst was found,

Discussion

Allen et al first recognized CHS in 19 patients presented with cannabis abuse and cyclical vomiting (Allen et al., 2004). The prevalence of marijuana use disorder has doubled in the period between 2001 and 2013 and 3 out of 10 have marijuana use disorder (Hasin et al., 2015). Δ9-tetrahydrocannabinol (THC) is the principle active compound in cannabis. THC is well known for its anti-emetic effect on the central nervous system, however Cannabidiol (CBD) and cannabigerol (CBG) are two additional

Conclusion

The number of CHS is likely to increase given the expected increase in use of legalized marijuana and hence physicians should have a high index of suspicion in a patient presenting with intractable vomiting and chronic cannabis abuse. Adequate and thorough knowledge of the understanding of CHS is imperative to provide optimal management.

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