Cannabis: A rare cause of acute pancreatitis

Context: Drugs of all types are related to the etiology of pancreatitis in approximately 2% of cases. However, there have been very few reports of acute pancreatitis associated with cannabis use in the general population. Case report: This report is the first such case in our country, and involves a 22-year-old North African man who presented to our emergency department with transfixiant epigastric abdominal pain, nausea and vomiting. The patient denied any past or familial medical history, was taking no medications chronically and had no history of trauma. The patient admitted to smoking one pack of cigarettes a day and occasional cannabis use, and no alcohol consumption. Biological and morphological explorations found Balthazar grade-A acute pancreatitis with no biliary dilatation or obstruction. The etiological workup was normal and, on repeat questioning, the patient admitted to being a regular and excessive user of cannabis, and to having done so 2 days before the abdominal pain. Conclusion: The use of cannabis is frequently seen worldwide and even in North Africa, and regular users, especially young adults, should be informed of the risk of this possible cannabis-induced pancreatic disease. This case should also be borne in mind, although the association of cannabis with pancreatitis is problematic because of the difficulty in monitoring cannabinoids in the body and the illegality of cannabis use and, consequently, getting patients to admit to using it. (C) 2012 Elsevier Masson SAS. All rights reserved.