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[大麻素呕吐综合征继发自发性纵隔气肿]

[Spontaneuos pneumomediastinum secondary to cannabinoid hyperemesis syndrome].

作者信息

Hernández-Ramos I, Parra-Esquivel P, López-Hernández Á, Burillo-Putze G

机构信息

Servicio de Urgencias. Hospital Universitario de Canarias. La Laguna. Tenerife..

出版信息

An Sist Sanit Navar. 2019 Aug 23;42(2):227-230. doi: 10.23938/ASSN.0635.

Abstract

Cannabinoid hyperemesis syndrome (CHS) is little known amongst clinicians and is characterised by abdominal pain and cyclical vomiting, after intense consumption of cannabis over several years. It does not respond to treatment with antiemetics, but does respond to showers in very hot water. We present the case of a 24-year-old patient whose antecedents included cannabis consumption since the age of 14 and an episode of spontaneous idiopathic pneumomediastinum (PM) the previous month, which presented an association of CHS and secondary pneumomediastinum with the intense, repeated vomiting of the CHS. He was given topical capsaicin and 5 mg of intravenous haloperidol, and was kept for 48 hours in the in A and E Short Stay Unit. This isolated clinical observation appears to indicate the need to rule out CHS as the cause of PM in young patients and, similarly, to consider the presence of PM in the clinical exploration of young people with CHS and in patients with pathologies whose aetiology might be influenced by an increase in intrathoracic pressure.

摘要

大麻素呕吐综合征(CHS)在临床医生中鲜为人知,其特征是在数年大量吸食大麻后出现腹痛和周期性呕吐。它对抗呕吐药治疗无反应,但对非常热的水淋浴有反应。我们报告一例24岁患者,其既往史包括自14岁起吸食大麻,以及前一个月发生的一次自发性特发性纵隔气肿(PM),该病例呈现出CHS与继发性纵隔气肿的关联,伴有CHS剧烈、反复的呕吐。给予其外用辣椒素和5毫克静脉注射氟哌啶醇,并在急症室短期留观单元留观48小时。这一孤立的临床观察结果似乎表明,有必要排除CHS作为年轻患者PM病因的可能性,同样,在对患有CHS的年轻人以及病因可能受胸内压升高影响的疾病患者进行临床检查时,也需考虑PM的存在。

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