Slipping Rib Syndrome Presenting as Postprandial Nausea: A Diagnostic Challenge in Internal Medicine

Slipping rib syndrome is an under-recognised cause of thoracoabdominal pain that may present with atypical symptoms, leading to diagnostic delay. We report the case of a 23-year-old woman who presented with severe postprandial nausea as her dominant symptom, accompanied by episodic vomiting and unintentional weight loss. Extensive gastrointestinal and spinal investigations were unrevealing, and symptoms were subsequently interpreted as functional or psychosomatic. Careful clinical examination and targeted imaging ultimately identified slipping rib syndrome involving the eleventh right rib. Surgical resection of the mobile cartilaginous rib segment resulted in complete and sustained resolution of symptoms. This case highlights the importance of considering musculoskeletal causes in patients with unexplained gastrointestinal symptoms to avoid misdiagnosis and unnecessary investigations.

Slipping rib syndrome may present predominantly with gastrointestinal symptoms such as postprandial nausea, leading to diagnostic delay.Reproducible mechanical symptoms on examination are key to diagnosis, and normal imaging does not exclude the condition.Surgical resection can provide definitive symptom relief in selected patients with persistent symptoms.