Case report: A case of undiagnosed cannabinoid hyperemesis syndrome in rural part of Nepal

INTRODUCTION: and importance: Cannabinoid, a widely used recreational drug worldwide. In Nepal, it is found easily and has multiple used as well as misused as a psychoactive substance. Despite having anti emetic property of Marijuana, chronic use of the substance can lead to cyclic vomiting syndrome due to effect in central nervous system and gastrointestinal system. CASE: we present a case of 28 year old man presented frequently with severe vomiting and abdominal pain which improved with hot showers and stopping use of cannabinoid. CLINICAL FINDINGS AND INVESTIGATION: Patient abdomen was tender but all other physical examinations were within normal limits. His lab investigations were within normal limit except of Total leukocyte count and urine analysis. INTERVENTION AND OUTCOME: The patient was hospitalized and treated for dehydration, nausea and vomiting, and abdominal pain. The patient was diagnosed with cannabinoid hyperemesis syndrome and was discharged from the hospital two days later with the advice to stop using cannabis completely.