Management of intractable hiccup

Area of Science:

• Medical Sciences
• Surgical Procedures
• Neurology

Background:

• Post-surgical hiccups (paroxysmal suprasternal spasms) can be a debilitating complication following abdominal surgery.
• Refractory hiccups pose a significant clinical challenge, often requiring invasive interventions.

Observation:

• A patient experienced intractable hiccups subsequent to a laparotomy.
• Multiple pharmacological agents were administered with minimal therapeutic benefit.

Findings:

• A left phrenic nerve crush intervention successfully resolved the patient's persistent hiccups.
• Literature review indicated chlorpromazine and metoclopramide as primary pharmacotherapies.
• Phrenic nerve injection or crush emerged as viable options for drug-refractory cases.

Implications:

• Phrenic nerve crush represents a potentially effective salvage therapy for intractable post-laparotomy hiccups.
• This case underscores the importance of considering interventional procedures when medical management fails.
• Further research into the mechanisms and optimal application of phrenic nerve interventions for hiccups is warranted.