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Acute pancreatitis as a rare adverse event among cannabis users: A systematic review

Jaiswal V 1 , Mukherjee D 2 , Batra N 3 , Ruchika F 4 , Susheela AT 5 , Chia JE 6 Show all authors , Mukherjee D 7 , Naz S 8 , Victor AA 9 , Pokhrel NB 10 , Song D 10 , Seen T 11 , Almas T 12 , Saleh MA 13 , Bansrao AS 13 , Mansoor E 14

Affiliations 

  • 1 Department of Medicine, AMA School of Medicine, Makati, Philippines
  • 2 Department of Medicine, Jinan University, People Republic of China
  • 3 Maulana Azad Medical College, New Delhi, India
  • 4 Department of Medicine, JJM Medical College, Davangere, Karnataka, India
  • 5 Department of Internal Medicine, Loyola MacNeal Hospital, Illinios, United States
  • 6 International Medical University, Kuala Lumpur, Malaysia
  • 7 Department of Medicine, St. George's University School of Medicine, United States
  • 8 Department of Medicine, BIDMC, Harvard Medical School, Boston, United States
  • 9 Universidad Autonoma de Baja California, California, United States
  • 10 Department of Medicine, Tribhuvan University Institute of Medicine, Kathmandu, Nepal
  • 11 Department of Internal Medicine, Icahn School of medicine at Mount Sinai, New York, United States
  • 12 Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
  • 13 Department of Gastroenterology, Cleveland Clinic, Ohio, United States
  • 14 Division of Gastroenterology and Liver Disease, University Hospital Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, United States
Medicine (Baltimore), 2022 Jul 01;101(26):e29822.
PMID: 35777067 DOI: 10.1097/MD.0000000000029822

Abstract

BACKGROUND: Cannabis use has been steadily rising in the United States and can have multiple adverse effects, including cannabis-induced acute pancreatitis. This study aims to collate and highlight the significant demographics, clinical presentation, and outcomes in patients with cannabis-induced acute pancreatitis.

METHOD: A systematic literature search of electronic databases for peer-reviewed articles was conducted. After an initial search, we found 792 articles through different electronic databases. After manually removing duplicates and articles that did not meet the criteria, 25 articles were included in our review.

RESULTS: A total of 45 patients were studied, 35 (78%) cases were male and 10 (22%) cases were female, showing male predominance. The mean age of all participants was 29.2 ± 10.3 years. The most common presenting symptoms were abdominal pain 21 of 21 (100%), nausea 17 of 21 (81%), and vomiting 12 of 20 (60%). Ultrasound was normal in the majority of patients, with findings of mild pancreatitis. Computerized tomography scans revealed pancreatic edema and inflammation in 7 of 20 (35%) patients, and findings of necrotizing pancreatitis and complex fluid collection were visualized in 3 of 20 (15%) patients. Dilatation of intrahepatic or extrahepatic biliary ducts was not seen in any patients. The overall prognosis was good, with reported full recovery.

CONCLUSIONS: Cannabis should be included in the differential diagnosis for the etiology of acute pancreatitis, which would help in early intervention and treatment for the mitigation of the rapidly progressive disease.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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