Published online Oct 7, 2015. doi: 10.3748/wjg.v21.i37.10704
Peer-review started: February 3, 2015
First decision: May 18, 2015
Revised: June 19, 2015
Accepted: August 25, 2015
Article in press: August 25, 2015
Published online: October 7, 2015
Processing time: 238 Days and 15.9 Hours
Addiction to synthetic cannabinoids (SCs) is a growing social and health problem worldwide. Chronic use of SCs may cause adverse effects in the gastrointestinal system. We describe a very rare case of acute gastric dilatation (AGD) and hepatic portal venous gas (HPVG), with findings of acute abdomen resulting from chronic use of a SC, Bonzai. AGD and HPVG were detected by computerized tomography examination. Patchy mucosal ischemia was seen in endoscopic examination. Despite the findings of an acute abdomen, a non-surgical approach with nasogastric decompression, antibiotic therapy, and close radiologic and endoscopic follow-up was preferred in the presented case. Clinical and radiologic findings decreased dramatically on the first day, and endoscopic findings gradually disappeared over 7 d. In conclusion, this case shows that chronic use of a SC may cause AGD and accompanying HPVG, which can be managed non-surgically despite the findings of acute abdomen.
Core tip: This is the first case of acute gastric dilatation and accompanying hepatic portal venous gas presenting as acute abdomen as a result of chronic use of a synthetic cannabinoid, Bonzai. Despite the findings of acute abdomen, this type of patient can be managed non-surgically with wide spectrum antibiotic therapy and close radiologic and endoscopic follow-up.