Persistent hiccups following endobronchial ultrasound-guided transbronchial needle aspiration

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic procedure widely used in modern pulmonary medicine. Major complications are rare and usually hemorrhagic or infectious, while neurological sequelae are exceptionally uncommon. We report a rare case of persistent hiccups following EBUS-TBNA in a middle-aged man evaluated for fever and necrotic mediastinal lymphadenopathy with a probable diagnosis of tuberculosis or invasive fungal diseases. Despite extensive investigations, including cross-sectional imaging and upper gastrointestinal endoscopy, no structural abnormalities such as mediastinitis or pleuritis were identified. The patient's hiccups were severe, interfered with sleep, and persistent despite oral intake of baclofen for 5 days; however, resolved within 2 days of combination therapy with baclofen and chlorpromazine. This case highlights that hiccups, although uncommon, may occur as a direct and debilitating iatrogenic complication of EBUS-TBNA, likely due to mechanical stimulation of mediastinal neural structures. Clinicians should be aware of this potential complication, particularly when hiccups occur immediately after the procedure.