OMS-IV Touro College of Osteopathic Medicine - Middletown Duncansville, Pennsylvania, United States
Case Diagnosis: Adult Intussusception
Case Description: A 38-year-old male with no past medical history presented to the emergency department with one week of sharp, intermittent, lower abdominal pain. Surgical history and social history were unremarkable except for chronic marijuana use. Physical examination was significant only for mild tenderness in the central lower abdomen without rebound, guarding, or rigidity. On CT scan, a small bowel intussusception was identified in the left mid abdomen. Intussusception is a rare finding in adults and even rarer without an associated mass. The patient was subsequently treated with conservative measures including pain control and restriction of oral intake. Follow up CT scan with oral contrast demonstrated resolution of the intussusception.
Discussions: Medical marijuana’s clinical application is still being explored as its legality has become widespread across the United States. In the field of physiatry, marijuana has shown potential use as an adjunctive method of pain control. As its popularity grows, potential long-term complications are still being discovered. In current literature, there has been a small number of cases of intussusception seen in chronic marijuana users. This case serves as a further example of marijuana-associated intussusception in an adult with no other risk factors. It is theorized that the tetrahydrocannabinol (THC) in marijuana activates CB1 receptors leading to decreased gastric emptying and alterations in gastric and intestinal motility. This decreased intestinal motility puts patients at risk for intussusception.
Conclusions: This case illustrates intussusception as a rare long-term complication of chronic marijuana use. As medical marijuana becomes increasingly common, it is important for physiatrists to be aware of potential associated complications.
