Cannabis Hyperemesis Syndrome: Given the patient's history of cyclical vomiting and marijuana use, this condition is a strong consideration. The syndrome is characterized by recurrent episodes of severe vomiting in long-term users of cannabis, which aligns with the patient's symptoms and history.

Gastroesophageal Reflux Disease (GERD): The wall thickening of the esophagus and stomach, as seen on the MRI, could suggest chronic inflammation consistent with GERD, which might contribute to the patient's nausea and vomiting.
Hepatic Congestion: The CT findings of extensive peripheral predominant hepatic congestion and periportal edema could indicate a problem with blood flow through the liver, possibly due to cardiac issues or other causes of increased pressure in the hepatic veins.
Cholelithiasis: Although there's no evidence of cholecystitis, the presence of lithiasis (gallstones) could potentially cause intermittent symptoms of nausea and vomiting, especially if the stones are obstructing the bile ducts.

Budd-Chiari Syndrome: This condition, characterized by hepatic vein thrombosis, could explain the hepatic congestion and periportal edema seen on the CT scan. It's a potentially life-threatening condition that requires prompt diagnosis and treatment.
Portal Vein Thrombosis: Similar to Budd-Chiari Syndrome, portal vein thrombosis could cause the observed CT findings and is a serious condition that needs to be ruled out.
Hepatic Artery Aneurysm or Thrombosis: These conditions could lead to the region of relative hypo-enhancement within the liver and are critical to diagnose due to their potential for severe complications.

Vascular Malformations or Tumors: Rare vascular malformations or tumors within the liver could potentially cause the observed imaging findings, including the hypoattenuating lesion and hepatic congestion.
Sickle Cell Disease with Hepatic Crisis: Given the patient's African-American background, sickle cell disease could be a consideration, especially if she has a history of the condition. A hepatic crisis could present with similar symptoms and imaging findings.
Wilson's Disease: This rare genetic disorder leads to copper accumulation in the liver and could potentially cause liver dysfunction and the observed imaging abnormalities, although it would typically present with more chronic symptoms and possibly neurological manifestations.