Abdominal Pain Management in a 17-Year-Old Female with Cannabis Use

Patient History and Presentation

The American College of Radiology recommends characterizing abdominal pain by location, onset, duration, quality, severity, and radiation to determine the underlying cause 1, 2, 3
Patients with abdominal pain and cannabis use should be asked about associated symptoms, including changes in bowel habits, which can be related to cannabinoid hyperemesis syndrome or other gastrointestinal disorders 1, 3
A thorough medical and surgical history, including previous abdominal surgeries and gastrointestinal disorders, is essential for determining the cause of abdominal pain 4, 5
The patient's medication history, including current medications and recent antibiotic use, should be considered when evaluating abdominal pain 4, 6

Laboratory tests, such as complete blood count and urinalysis, can help identify underlying causes of abdominal pain, including infections and urinary tract infections 1, 4
Imaging considerations, including CT abdomen and pelvis with IV contrast, can help diagnose serious pathology, such as appendicitis, cholecystitis, and pancreatitis 1, 2, 3, 8
A differential diagnosis should include conditions such as appendicitis, inflammatory bowel disease, and pancreatitis, which can be identified through laboratory tests and imaging studies 1, 3, 5

Immediate management of abdominal pain may include IV fluid rehydration and pain management options, depending on the underlying cause and severity of symptoms 4, 6
The American College of Radiology recommends CT abdomen and pelvis with IV contrast as the primary imaging modality for evaluating abdominal pain in patients with cannabis use 1, 2, 8
Treatment considerations should be based on the identified pathology, and may include specific treatments for conditions such as inflammatory bowel disease and functional abdominal pain 4, 5, 6