{"id":"https://openalex.org/W7214968397","doi":"https://doi.org/10.7759/cureus.117214","title":"Normal on the Inside: A Case of Recurrent Abdominal Pain, Equivocal CT Appendicitis, and Histologically Normal Appendix in an Adolescent With Chronic Cannabis Use","display_name":"Normal on the Inside: A Case of Recurrent Abdominal Pain, Equivocal CT Appendicitis, and Histologically Normal Appendix in an Adolescent With Chronic Cannabis Use","publication_year":2026,"publication_date":"2026-09-30","ids":{"openalex":"https://openalex.org/W7214968397","doi":"https://doi.org/10.7759/cureus.117214","pmid":"https://pubmed.ncbi.nlm.nih.gov/42965212","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13722353"},"language":"en","primary_location":{"id":"doi:10.7759/cureus.117214","doi":"https://doi.org/10.7759/cureus.117214","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.117214","pdf_url":"https://www.cureus.com/articles/511530-normal-on-the-inside-a-case-of-recurrent-abdominal-pain-equivocal-ct-appendicitis-and-histologically-normal-appendix-in-an-adolescent-with-chronic-cannabis-use.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://www.cureus.com/articles/511530-normal-on-the-inside-a-case-of-recurrent-abdominal-pain-equivocal-ct-appendicitis-and-histologically-normal-appendix-in-an-adolescent-with-chronic-cannabis-use.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5135910499","display_name":"Nazar Abdelgabar","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2801633153","display_name":"Isle of Wight NHS Trust","ror":"https://ror.org/013aa1717","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801633153"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Nazar Abdelgabar","raw_affiliation_strings":["Gastroenterology and Hepatology, St Mary's Hospital, Isle of Wight, GBR"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Gastroenterology and Hepatology, St Mary's Hospital, Isle of Wight, GBR","institution_ids":["https://openalex.org/I2801633153"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5135957907","display_name":"Yahia Khalil","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2801633153","display_name":"Isle of Wight NHS Trust","ror":"https://ror.org/013aa1717","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801633153"]}],"countries":["GB"],"is_corresponding":true,"raw_author_name":"Yahia Khalil","raw_affiliation_strings":["General Surgery, St Mary's Hospital, Isle of Wight, GBR"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"General Surgery, St Mary's Hospital, Isle of Wight, GBR","institution_ids":["https://openalex.org/I2801633153"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5120401930","display_name":"Karrar Al-Balootti","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2801120809","display_name":"Salford Royal NHS Foundation Trust","ror":"https://ror.org/019j78370","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801120809","https://openalex.org/I4405259061"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Karrar Al-Balootti","raw_affiliation_strings":["Neurosurgery, Salford Royal NHS Foundation Trust, Salford, GBR"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Neurosurgery, Salford Royal NHS Foundation Trust, Salford, GBR","institution_ids":["https://openalex.org/I2801120809"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5106621473","display_name":"Raya Abu-Khalaf","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I142762351","display_name":"Royal College of Surgeons in Ireland","ror":"https://ror.org/01hxy9878","country_code":"IE","type":"education","lineage":["https://openalex.org/I142762351"]}],"countries":["IE"],"is_corresponding":false,"raw_author_name":"Raya Abu-Khalaf","raw_affiliation_strings":["Medicine, Royal College of Surgeons in Ireland, Dublin, IRL"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Medicine, Royal College of Surgeons in Ireland, Dublin, IRL","institution_ids":["https://openalex.org/I142762351"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5153608919","display_name":"Mohammad Z Khalil","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I248769658","display_name":"Royal College of Surgeons in Ireland - Bahrain","ror":"https://ror.org/01h4bh480","country_code":"BH","type":"education","lineage":["https://openalex.org/I142762351","https://openalex.org/I248769658"]}],"countries":["BH"],"is_corresponding":false,"raw_author_name":"Mohammad Z Khalil","raw_affiliation_strings":["Cardiology, Royal College of Surgeons in Ireland-Bahrain, Busaiteen, BHR"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Cardiology, Royal College of Surgeons in Ireland-Bahrain, Busaiteen, BHR","institution_ids":["https://openalex.org/I248769658"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5106621474","display_name":"Layan Abu-Khalaf","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2801018919","display_name":"Blackpool Victoria Hospital","ror":"https://ror.org/01r9ea713","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801018919","https://openalex.org/I4210127133"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Layan Abu-Khalaf","raw_affiliation_strings":["Psychiatry, Blackpool Victoria Hospital, Blackpool, GBR"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Psychiatry, Blackpool Victoria Hospital, Blackpool, GBR","institution_ids":["https://openalex.org/I2801018919"]}]}],"institutions":[],"countries_distinct_count":3,"institutions_distinct_count":5,"corresponding_author_ids":["https://openalex.org/A5135957907"],"corresponding_institution_ids":["https://openalex.org/I2801633153"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.73500876,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"18","issue":"9","first_page":"e117214","last_page":"e117214"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11473","display_name":"Appendicitis Diagnosis and Management","score":0.9359999895095825,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11473","display_name":"Appendicitis Diagnosis and Management","score":0.9359999895095825,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13962","display_name":"Omental and Epiploic Conditions","score":0.008999999612569809,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10414","display_name":"Cannabis and Cannabinoid Research","score":0.004999999888241291,"subfield":{"id":"https://openalex.org/subfields/2736","display_name":"Pharmacology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/recurrent-abdominal-pain","display_name":"recurrent abdominal pain","score":0.9660000205039978},{"id":"https://openalex.org/keywords/cannabis-use","display_name":"cannabis use","score":0.7329999804496765},{"id":"https://openalex.org/keywords/adolescents","display_name":"adolescents","score":0.9139999747276306},{"id":"https://openalex.org/keywords/appendicitis-misdiagnosis","display_name":"appendicitis misdiagnosis","score":0.6480000019073486}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9926999807357788},{"id":"https://openalex.org/C2776364125","wikidata":"https://www.wikidata.org/wiki/Q9656","display_name":"Appendix","level":2,"score":0.7652999758720398},{"id":"https://openalex.org/C2777056318","wikidata":"https://www.wikidata.org/wiki/Q79817","display_name":"Cannabis","level":2,"score":0.559499979019165},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.4438999891281128},{"id":"https://openalex.org/C2779983558","wikidata":"https://www.wikidata.org/wiki/Q9597","display_name":"Abdomen","level":2,"score":0.41040000319480896},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.36239999532699585},{"id":"https://openalex.org/C2780016130","wikidata":"https://www.wikidata.org/wiki/Q121041","display_name":"Appendicitis","level":2,"score":0.3124000132083893},{"id":"https://openalex.org/C544519230","wikidata":"https://www.wikidata.org/wiki/Q32566","display_name":"Computed tomography","level":2,"score":0.30480000376701355},{"id":"https://openalex.org/C61434518","wikidata":"https://www.wikidata.org/wiki/Q932510","display_name":"General surgery","level":1,"score":0.30059999227523804},{"id":"https://openalex.org/C2987552334","wikidata":"https://www.wikidata.org/wiki/Q383126","display_name":"Chronic disease","level":2,"score":0.2930999994277954},{"id":"https://openalex.org/C2780313146","wikidata":"https://www.wikidata.org/wiki/Q4358078","display_name":"Effects of cannabis","level":4,"score":0.2921999990940094},{"id":"https://openalex.org/C2780955771","wikidata":"https://www.wikidata.org/wiki/Q183425","display_name":"Abdominal pain","level":2,"score":0.2572999894618988}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.7759/cureus.117214","doi":"https://doi.org/10.7759/cureus.117214","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.117214","pdf_url":"https://www.cureus.com/articles/511530-normal-on-the-inside-a-case-of-recurrent-abdominal-pain-equivocal-ct-appendicitis-and-histologically-normal-appendix-in-an-adolescent-with-chronic-cannabis-use.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},{"id":"pmid:42965212","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42965212","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"Case Reports"},{"id":"pmh:oai:pubmedcentral.nih.gov:13722353","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13722353/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.7759/cureus.117214","doi":"https://doi.org/10.7759/cureus.117214","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.117214","pdf_url":"https://www.cureus.com/articles/511530-normal-on-the-inside-a-case-of-recurrent-abdominal-pain-equivocal-ct-appendicitis-and-histologically-normal-appendix-in-an-adolescent-with-chronic-cannabis-use.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7214968397.pdf","grobid_xml":"https://content.openalex.org/works/W7214968397.grobid-xml"},"referenced_works_count":16,"referenced_works":["https://openalex.org/W2017626638","https://openalex.org/W2118695126","https://openalex.org/W2129212517","https://openalex.org/W2345655271","https://openalex.org/W2530421615","https://openalex.org/W2594572760","https://openalex.org/W2599457451","https://openalex.org/W2894194385","https://openalex.org/W2954644870","https://openalex.org/W3199913377","https://openalex.org/W4293230553","https://openalex.org/W4296402765","https://openalex.org/W4382364882","https://openalex.org/W4387563339","https://openalex.org/W4401728137","https://openalex.org/W7117272440"],"related_works":["https://openalex.org/W2072270264","https://openalex.org/W2903215662","https://openalex.org/W7107945456","https://openalex.org/W2050403583","https://openalex.org/W4210410683","https://openalex.org/W3096482388","https://openalex.org/W2978913755","https://openalex.org/W2763952684","https://openalex.org/W7125957695","https://openalex.org/W2980210494"],"abstract_inverted_index":{"Cyclic":[0],"vomiting":[1],"syndrome":[2,7],"(CVS)":[3],"and":[4,13,42,49,62,79,116,154,171],"cannabinoid":[5],"hyperemesis":[6],"(CHS)":[8],"are":[9,159],"diagnoses":[10,59],"of":[11,24,54,60,76,137,151],"exclusion,":[12],"both":[14],"can":[15],"anchor":[16],"clinical":[17],"thinking":[18],"in":[19,174],"ways":[20],"that":[21],"delay":[22],"recognition":[23],"organic":[25],"pathology.":[26],"We":[27],"describe":[28],"an":[29],"18-year-old":[30],"male":[31],"patient":[32,132],"who":[33],"attended":[34],"the":[35,77,111,149,177,191],"emergency":[36],"department":[37],"repeatedly":[38],"between":[39],"December":[40],"2025":[41],"June":[43],"2026":[44,72],"with":[45,87,125,135,145],"severe":[46],"abdominal":[47],"pain":[48],"vomiting,":[50],"against":[51],"a":[52,83,121],"background":[53],"chronic":[55],"cannabis":[56],"use.":[57],"Working":[58],"CHS":[61],"CVS":[63],"were":[64],"recorded":[65],"across":[66],"multiple":[67],"admissions.":[68],"During":[69],"his":[70,138],"March":[71],"admission,":[73],"contrast-enhanced":[74],"CT":[75,167],"abdomen":[78],"pelvis":[80],"(CTAP)":[81],"showed":[82],"mildly":[84,114],"thickened":[85],"appendix":[86,112,123],"small-volume":[88],"pelvic":[89],"free":[90],"fluid,":[91],"reported":[92],"as":[93],"mild":[94],"acute":[95,139],"appendicitis.":[96],"Conservative":[97],"management":[98],"was":[99,108,133,163],"commenced":[100],"but":[101,141],"failed":[102],"to":[103,187],"resolve":[104],"symptoms.":[105],"Laparoscopic":[106],"appendicectomy":[107],"performed.":[109],"Intraoperatively,":[110],"appeared":[113],"dilated":[115],"injected.":[117],"Histopathological":[118],"analysis":[119],"returned":[120],"normal":[122],"vermiformis":[124],"no":[126],"inflammation,":[127],"dysplasia,":[128],"or":[129],"malignancy.":[130],"The":[131],"discharged":[134],"resolution":[136],"symptoms":[140],"re-presented":[142],"within":[143],"weeks":[144],"identical":[146],"complaints.":[147],"At":[148],"time":[150],"writing,":[152],"oesophagogastroduodenoscopy":[153],"familial":[155],"Mediterranean":[156],"fever":[157],"testing":[158],"pending.":[160],"Faecal":[161],"calprotectin":[162],"159":[164],"microg/g.":[165],"When":[166],"findings,":[168],"operative":[169],"appearances,":[170],"histology":[172],"point":[173],"different":[175],"directions,":[176],"underlying":[178],"diagnosis":[179],"is":[180],"not":[181],"resolved":[182],"by":[183],"surgery;":[184],"it":[185],"has":[186],"be":[188],"reconsidered":[189],"from":[190],"beginning.":[192]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-10-01T00:00:00"}
