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Author: Ashley Grigsby, DO, PGY-3
Indiana University, Emergency Medicine/Pediatrics
Case
A 21-year-old female presented with epigastric abdominal pain and severe vomiting for the last three days. She has had similar vomiting episodes before and has had a large workup that was unremarkable for the etiology. She was unable to stay hydrated during this latest episode so she presented to the emergency department (ED). She stated that the only thing that helped her vomiting has been a hot shower. Her vitals were normal except for a heart rate of 112 beats per minute; her exam was unremarkable except for mild epigastric tenderness to palpation. The patient was questioned multiple times alone in the room and denied, multiple times, any marijuana use or other drug use. She was treated symptomatically and improved. On discharge, she was again questioned about drug use and admitted to twice daily marijuana use for the past several years. She was diagnosed with cannabinoid hyperemesis syndrome, counseled on the importance of marijuana cessation, and discharged home in good condition.
