scholarly journals Cannabinoid Hyperemesis Syndrome: A Case Report of Cyclic Severe Hyperemesis and Abdominal Pain with Long-Term Cannabis Use

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Julia Hermes-Laufer ◽  
Lola Del Puppo ◽  
Ihsan Inan ◽  
François-Xavier Troillet ◽  
Omar Kherad
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
D2 Receptor ◽  
Rare Condition ◽  
Final Diagnosis ◽  
Cannabis Use ◽  
Severe Nausea ◽  
Cannabis Consumption ◽  
Cannabinoid Hyperemesis Syndrome

Introduction.Cannabinoid Hyperemesis Syndrome (CHS) is a rare condition that includes cyclic severe vomiting in subjects who have been consuming large doses of cannabis for several years. One of the major diagnostic criteria is the alleviation of symptoms by hot showers. The syndrome was first described in 2004 and is so far neither completely understood nor well known. The latter leads to continued morbidity in concerned subjects and unnecessary expenses for futile investigations. Standard treatments of vomiting as 5-HT3 or D2-receptor antagonists have been shown to be ineffective in alleviating the symptoms. The only long-term satisfying treatment option is the complete abstinence from cannabis consumption.Case Summary.In this case report we describe a 26-year-old male Caucasian long-term cannabis consumer who repeatedly presented in our emergency room with cyclic severe nausea and vomiting ceased by hot showers and resistant to all other treatments. The final diagnosis was not established until his third visit to the ER.Conclusion.CHS is an important differential diagnosis in patients who present with cyclic vomiting and abdominal pain with a history of long-term cannabis use. Recognition of this syndrome is important in order to avoid unnecessary clinical testing and to help the patients break the cycle of drug use.

Management of Cannabinoid Hyperemesis Syndrome: Focus on Capsaicin

2020 ◽  
pp. 089719002093428
Author(s):  
Janice L. Stumpf ◽  
Lauren D. Williams
Keyword(s):  
Abdominal Pain ◽  
Clinical Presentation ◽  
Marijuana Use ◽  
Hot Water ◽  
Severe Nausea ◽  
Trpv1 Receptors ◽  
Cannabinoid Hyperemesis Syndrome ◽  
Topical Capsaicin

Cannabinoid hyperemesis syndrome is a condition characterized by cyclic severe nausea, vomiting, and abdominal pain associated with frequent, long-term marijuana use. The condition resolves with cessation of cannabis but may be temporarily relieved by bathing in hot water. Topical capsaicin cream may also alleviate symptoms, perhaps through antiemetic effects produced by activation of TRPV1 receptors, similar to that of hot water bathing. This review summarizes the epidemiology, clinical presentation, diagnosis, pathophysiology, and management of cannabinoid hyperemesis syndrome, focusing on treatment with topical capsaicin.

Cannabinoid hyperemesis syndrome

2016 ◽  
Vol 33 (S1) ◽  
pp. S306-S307 ◽  
Author(s):  
S. López-Romeo ◽  
G. Ledesma-Iparraguirre
Keyword(s):  
Abdominal Pain ◽  
Outpatient Service ◽  
Somatoform Disorder ◽  
Cannabis Use ◽  
Abdominal Ultrasonography ◽  
Cannabinoid Hyperemesis Syndrome ◽  
History Of ◽  
Disorder Treatment ◽  
Competing Interest

Case reportA 25-year-old man was attended in multiple times at Emergency Department by referring abdominal pain and vomiting. No organic disease was found and he was referred to Psychiatric Emergency to assess him. He had history of cannabis use (4–5 times/day) during last 5 years. He referred recurrent episodes of abdominal pain and vomiting since 4 years ago, he had found that having hot showers alleviate his symptoms. Urine screening was positive for THC and negative for other drugs. In results of blood tests, abdominal X-ray, abdominal ultrasonography, abdominal tomography and fibrogastroscopy didn’t find any abnormality. He was diagnosed from suffering a somatoform disorder. Treatment with Setraline 50 mg/day was prescribed and cannabis abstinence was recommended. He was referred to Mental Health outpatient service. He maintained cannabis abstinence for 1 month and some symptoms disappeared. However, 2 months later, he relapsed in cannabis use and all symptoms reappeared. Later he achieved cannabis abstinence again and he got full recovery, then he was diagnosed from cannabinoid hyperemesis syndrome.ConclusionCannabinoid hyperemesis syndrome is characterized by recurrent nausea, vomiting and colicky abdominal pain in patients with long-term cannabis use. These symptoms have been reported to be alleviated temporarily by taking a hot shower or more permanently by abstaining from the use of cannabis. The phenomenon of cannabinoid hyperemesis and clinical diagnosis remained obscure until recently. For this reason, it is necessary to take it into account in order to recognize it and help provide these patients early and better approach.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Cannabinoid Hyperemesis

2010 ◽  
Vol 24 (5) ◽  
pp. 284-285 ◽  
Author(s):  
Stephen Sullivan
Keyword(s):  
Abdominal Pain ◽  
Eating Disorder ◽  
Cannabis Use ◽  
Cyclic Vomiting Syndrome ◽  
Severe Nausea ◽  
Drug Seeking ◽  
Temporary Relief ◽  
Cannabinoid Hyperemesis Syndrome ◽  
Hot Bath ◽  
Cyclic Vomiting

Cannabinoid hyperemesis syndrome is characterized by chronic, heavy use of cannabis, recurrent episodes of severe nausea and intractable vomiting, and abdominal pain. Temporary relief of symptoms is achieved by taking a hot bath or shower, and resolution of the problem when cannabis use is stopped. Failure to recognize the syndrome leads to misdiagnoses such as psychogenic vomiting, the cyclic vomiting syndrome, an eating disorder or ‘drug-seeking behaviour’, and may lead to extensive, expensive and unproductive investigations, psychiatric referrals and ineffective treatments. Other than stopping cannabis use, there is no proven treatment. Why a substance known for its antiemetic properties should cause such a syndrome is unknown.

scholarly journals Torsion of the Ovary in Infancy, a Rare Emergency; A Case Report

2021 ◽  
pp. 90-96
Author(s):  
Abdelilah Radi ◽  
Karima Larbi Ouassou ◽  
Amal Hassani ◽  
Rachid Abilkassem ◽  
Aomar Agadr ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Clinical Evaluation ◽  
Clinical Picture ◽  
Acute Abdominal Pain ◽  
Rare Condition ◽  
Ovarian Torsion ◽  
Positive Diagnosis ◽  
Hemorrhagic Risk ◽  
Made In

Torsion of the ovary is a rare condition whose diagnosis remains difficult given the non-specificity of the clinical picture as well as the difficulty of clinical evaluation, especially in young girls. It is a surgical emergency because it involves the vital prognosis by the hemorrhagic risk, and functional prognosis by the risk of infertility. The clinical picture is dominated by acute abdominal pain. Our work reports the case of a 2-year-old girl in whom the diagnosis of ovarian torsion was made in front of an atypical clinical picture. Laparoscopy is the method of choice for making a positive diagnosis and performing a conservative procedure as described in this work.

scholarly journals LO48: Pediatric cannabinoid hyperemesis syndrome in the emergency department: a 5-year retrospective review

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S24-S24
Author(s):  
D. Foster ◽  
K. Van Aarsen ◽  
J. Yan ◽  
J. Teefy ◽  
T. Lynch
Keyword(s):  
Emergency Department ◽  
Weight Loss ◽  
Abdominal Pain ◽  
Pediatric Patients ◽  
Venous Blood ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Cannabis Use ◽  
Discharge Diagnosis ◽  
Cannabinoid Hyperemesis Syndrome

Introduction: Cannabinoid Hyperemesis Syndrome (CHS) in pediatric patients is poorly characterized. Literature is scarce, making identification and treatment challenging. This study's objective was to describe demographics and visit data of pediatric patients presenting to the emergency department (ED) with suspected CHS, in order to improve understanding of the disorder. Methods: A retrospective chart review was conducted of pediatric patients (12-17 years) with suspected CHS presenting to one of two tertiary-care EDs; one pediatric and one pediatric/adult (combined annual pediatric census 40,550) between April 2014-March 2019. Charts were selected based on discharge diagnosis of abdominal pain or nausea/vomiting with positive cannabis urine screen, or discharge diagnosis of cannabis use, using ICD-10 codes. Patients with confirmed or likely diagnosis of CHS were identified and data including demographics, clinical history, and ED investigations/treatments were recorded by a trained research assistant. Results: 242 patients met criteria for review. 39 were identified as having a confirmed or likely diagnosis of CHS (mean age 16.2, SD 0.85 years with 64% female). 87% were triaged as either CTAS-2 or CTAS-3. 80% of patients had cannabis use frequency/duration documented. Of these, 89% reported at least daily use, the mean consumption was 1.30g/day (SD 1.13g/day), and all reported ≥6 months of heavy use. 69% of patients had at least one psychiatric comorbidity. When presenting to the ED, all had vomiting, 81% had nausea, 81% had abdominal pain, and 30% reported weight loss. Investigations done included venous blood gas (30%), pregnancy test in females (84%), liver enzymes (57%), pelvic or abdominal ultrasound (19%), abdominal X-ray (19%), and CT head (5%). 89% of patients received treatment in the ED with 81% receiving anti-emetics, 68% receiving intravenous (IV) fluids, and 22% receiving analgesics. Normal saline was the most used IV fluid (80%) and ondansetron was the most used anti-emetic (90%). Cannabis was suspected to account for symptoms in 74%, with 31% of these given the formal diagnosis of CHS. 62% of patients had another visit to the ED within 30 days (prior to or post sentinel visit), 59% of these for similar symptoms. Conclusion: This study of pediatric CHS reveals unique findings including a preponderance of female patients, a majority that consume cannabis daily, and weight loss reported in nearly one third. Many received extensive workups and most had multiple clustered visits to the ED.

scholarly journals Retenção Urinária Como Manifestação de Hematocolpos

2020 ◽  
Vol 33 (13) ◽  
Author(s):  
Íris Santos Silva ◽  
Renata Martello ◽  
António Mendes ◽  
Albertino Chaves
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Case Report ◽  
Urinary Retention ◽  
Genital Tract ◽  
Rare Condition ◽  
Tanner Stage ◽  
Imperforate Hymen ◽  
Uncommon Condition ◽  
Rare Symptom

Hematocolpos is an obstruction of the menstrual flow due to an anomaly of the genital tract, with imperforate hymen being the most common one. It is an uncommon condition, with a prevalence of 1:1000 – 1:16 000. It is usually an asymptomatic condition until the onset of menarche, when there is accumulation of blood in the vagina (hematocolpos) or in the uterus (hematometra). A rare symptom of hematocolpos could be urinary retention. Our case report is about a 12-year-old girl, with no menarche and Tanner stage M4/P5, who was admitted to our emergency department with abdominal pain and urinary retention. A brief review of this rare condition is presented, in order to remind clinicians about its existence, so that it can be diagnosed and treated as quickly as possible.

Long-term Uncontrolled Hereditary Gingival Fibromatosis: A Case Report

2007 ◽  
Vol 8 (1) ◽  
pp. 90-96 ◽  
Author(s):  
Dilek Şengün ◽  
Hasan Hatipoğlu ◽  
Müjgan Güngör Hatipoğlu
Keyword(s):  
Case Report ◽  
Rare Condition ◽  
Gingival Hyperplasia ◽  
Gingival Overgrowth ◽  
Mucoperiosteal Flap ◽  
Gingival Fibromatosis ◽  
Mandibular Teeth ◽  
One Year ◽  
Almost All

Abstract Hereditary gingival fibromatosis (HGF) is a rare condition characterized by varying degrees of gingival hyperplasia. Gingival fibromatosis usually occurs as an isolated disorder or can be associated with a variety of other syndromes. A 33-year-old male patient who had a generalized severe gingival overgrowth covering two thirds of almost all maxillary and mandibular teeth is reported. A mucoperiosteal flap was performed using interdental and crevicular incisions to remove excess gingival tissues and an internal bevel incision to reflect flaps. The patient was treated 15 years ago in the same clinical facility using the same treatment strategy. There was no recurrence one year following the most recent surgery. Citation Şengün D, Hatipoğlu H, Hatipoğlu MG. Long-term Uncontrolled Hereditary Gingival Fibromatosis: A Case Report. J Contemp Dent Pract 2007 January;(8)1:090-096.

scholarly journals Pharmacology and effects of cannabis: A brief review

2001 ◽  
Vol 178 (2) ◽  
pp. 101-106 ◽  
Author(s):  
C. Heather Ashton
Keyword(s):  
Health Risks ◽  
Cardiovascular Health ◽  
Recent Literature ◽  
The Body ◽  
Cannabis Use ◽  
Young Population ◽  
Cannabis Consumption ◽  
The Individual ◽  
Endogenous Cannabinoid

BackgroundIncreasing prevalence of recreational cannabis use among the young population has stimulated debate on the possible effects of acute and long-term use.AimsTo highlight recent knowledge of mechanisms of action, effects on psychomotor and cognitive performance, and health risks associated with cannabis consumption.MethodA brief review of recent literature on the prevalence of recreational cannabis use, the potency of modern cannabis preparations and the pharmacological actions of cannabis.ResultsCannabinoids derived from herbal cannabis interact with endogenous cannabinoid systems in the body. Actions on specific brain receptors cause dose-related impairments of psychomotor performance with implications for car and train driving, aeroplane piloting and academic performance. Other constituents of cannabis smoke carry respiratory and cardiovascular health risks similar to those of tobacco smoke.ConclusionsCannabis is not, as widely perceived, a harmless drug but poses risks to the individual and to society.

scholarly journals Cerebellar Abscess Mimicking Recurrent Pilocytic Astrocytoma: A Case Report

2016 ◽  
Vol 12 (2) ◽  
pp. 85-87
Author(s):  
Harihar Devkota ◽  
Rajiv Jha
Keyword(s):  
Case Report ◽  
Children And Adolescents ◽  
Pilocytic Astrocytoma ◽  
Preoperative Diagnosis ◽  
Rare Condition ◽  
Final Diagnosis ◽  
Cerebellar Abscess ◽  
Septic Focus ◽  
Operative Findings ◽  
Space Occupying Lesion

Cerebellar abscess is a rare condition occurring more commonly in children and adolescents usually caused by otitis media. They can occur following trauma or surgery or from septic focus directly or hematologically. It is sometime hard to distinguish from other space occupying lesion clinically or by imaging modalities. We report a case of an eight year boy who had undergone craniotomy and excision of a pilocytic astrocytoma two years back and now presented with headache and preoperative diagnosis of recurrent pilocytic astrocytoma was made. But, to our surprise, the operative findings showed an abscess which was confirmed with histopathology. The final diagnosis of cerebellar abscess was made.Nepal Journal of Neuroscience 12:85-87, 2015

scholarly journals Cannabinoid Hyperemesis Syndrome: An Unexpected Problem in an Unusual Setting—A Case Report

2020 ◽  
Vol 185 (9-10) ◽  
pp. e1894-e1896
Author(s):  
Rory Stuart ◽  
John Ray Richards
Keyword(s):  
Emergency Department ◽  
Acute Kidney Injury ◽  
Abdominal Pain ◽  
Case Report ◽  
Kidney Injury ◽  
Southwest Asia ◽  
Severe Dehydration ◽  
Military Hospitals ◽  
Us Military ◽  
Cannabinoid Hyperemesis Syndrome

Abstract Cannabinoid hyperemesis syndrome presents with abdominal pain, nausea, and intractable vomiting caused by phytogenic and synthetic cannabinoid use. Complications associated with this disorder range from severe dehydration to acute kidney injury and rhabdomyolysis. This syndrome mimics many acute surgical and emergency medical conditions and can present several diagnostic and treatment challenges. While this syndrome is increasingly recognized as a common clinical entity in civilian emergency departments, there is little data concerning experience at military hospitals. We present a case of cannabinoid hyperemesis syndrome that was diagnosed and treated in a combat-zone US military emergency department in Southwest Asia.

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