Cannabis-induced acute pancreatitis: a case report with comprehensive literature review

D. Pagliari, A. Saviano, M.G. Brizi, F.A. Mancarella, F. Cannone, M. Musso, L. Franza, F. Attili, A. Gasbarrini

Internal Medicine and Gastroenterology and Pancreatic Unit, Department of Radiology, Institute of Internal Medicine, Digestive Endoscopy Unit; Fondazione Policlinico Universitario A. Gemelli – IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. saviange@libero.it

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• Pharmacology

OBJECTIVE: Cannabis is an illegal drug that has been under the spotlight in recent years, due to its vast array of effects on different biological systems. The role of cannabis has been investigated in the management of pain in acute pancreatitis (AP), even though some studies suggest that it may have a causative effect in this pathology and could be considered the underlying etiology in some cases of idiopathic AP. In this case report, we discuss the case of a young man who presented with three different episodes of AP, with apparently no significant history of alcohol and drug consumption, and with no evidence of a biliary, genetic or, autoimmune etiology. During the third episode, in which he had developed a voluminous pseudocyst, treated trough ultrasound (EUS)-guided drainage, he admitted consumption of cannabis daily. The Naranjo score resulted to be 6 (confirming the possible causality), and it was suggested to the patient to avoid cannabis consumption. Since then, he did not develop any other AP episodes. In summary, cannabis should be considered among the possible AP etiologies, as its causative identification and interruption may significantly improve the course of several idiopathic APs.

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