Cannabis hyperemesis triggered dangerous blood pressure spikes in a patient with adrenal tumor

Cannabinoid-induced hyperemesis caused repeated violent retching in a patient with an 8 cm adrenal pheochromocytoma. The retching physically compressed the tumor, triggering catecholamine surges and hypertensive urgency requiring ICU admission and multiple antihypertensive medications.

Single case report of a 69-year-old male presenting to the emergency department with nausea, vomiting, and hypertensive urgency. History of daily cannabis use for many years with repeated hyperemesis episodes.

This case illustrates an unusual but dangerous interaction between cannabinoid hyperemesis syndrome and an underlying condition. It also highlights how CHS can have consequences beyond the GI symptoms themselves.

While this specific combination is rare, it demonstrates how chronic cannabis use can create unexpected medical emergencies through indirect mechanisms. Clinicians treating CHS should consider whether violent retching could exacerbate other conditions.

Single case report cannot establish generalized risk. This combination of conditions is extremely rare. The patient also had years of daily cannabis use.