High Alert For Cannabinoid Hyperemesis Syndrome: A Case Report

Background:?A 32-year-old Caucasian man presented with intractable nausea, psychogenic vomiting, abdominal pain and compulsive hot-water bathing behaviors following the habitual use of cannabis for years, consistent with the uncommon and frequently overlooked diagnosis of Cannabinoid Hyperemesis Syndrome. This was his third admission to the emergency department with the same complaints and symptoms which had persisted for over two years without a recognizable etiology. All imaging studies done on each visit were unremarkable. Results:?The patient was clinically symptomatic with the aforementioned presenting complaints, but disappeared upon discontinuation of the cannabis. Within two days of supportive treatment in addition to temporary relief of symptoms with bathing. To date, no effective cure has been sought for this unique diagnosis other than abstaining from cannabis use. Conclusion:?A complete recovery was made three days following admission. The presenting symptoms were attributed to the smoking behaviors. The patient was followed up by his primary care physician once released from the hospital. A very rare diagnosis surfaced a number of times with the same patient in the same setting over the span of a couple years, but was overlooked due to its rarity. Hence, physicians should list it higher on their differentials when dealing with a patient with a history of drug abuse.