Tuberc Respir Dis.  2008 Jan;64(1):39-43. 10.4046/trd.2008.64.1.39.

A Case of Persistent Hiccup in a Patient with Non-small Cell Lung Cancer

• Park HS
• Sim YS
• Lim SY
• Jo JY
• Kwon SS
• Roh SH
• Kim YR
• Chun EM
• Lee JH
• Ryu YJ
• Song DE
• Moon JW

• KMID: 1478140
• DOI: http://doi.org/10.4046/trd.2008.64.1.39

Abstract

A hiccup is caused by involuntary, intermittent, and spasmodic contractions of the diaphragm and intercostal muscles. It starts with a sudden inspiration and ends with an abrupt closure of the glottis. Even though a hiccup is thought to develop through the hiccup reflex arc, its exact pathophysiology is still unclear. The etiologies include gastrointestinal disorders, respiratory abnormalities, psychogenic factors, toxic-metabolic disorders, central nervous system dysfunctions and irritation of the vagus and phrenic nerves. Most benign hiccups can be controlled by traditional empirical therapy such as breath holding and swallowing water. However, though rare, a persistent hiccup longer than 48 hours can lead to significant adverse effects including malnutrition, dehydration, insomnia, electrolyte imbalance, and cardiac arrhythmia. An intractable hiccup can sometimes even cause death. We herein describe a patient with non-small cell lung cancer who was severely distressed by a persistent hiccup.

Keyword

Chlorpromazine; Hiccup; Lung cancer; Singultus

MeSH Terms

Arrhythmias, Cardiac
Breath Holding
Carcinoma, Non-Small-Cell Lung
Central Nervous System
Chlorpromazine
Contracts
Deglutition
Dehydration
Diaphragm
Glottis
Hiccup
Humans
Intercostal Muscles
Lung Neoplasms
Malnutrition
Phrenic Nerve
Reflex
Sleep Initiation and Maintenance Disorders
Water
Chlorpromazine
Water

Figure

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  Figure 1 Chest X-ray on admission shows a large amount of pleural effusion in the left hemithorax.

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  Figure 2 Chest CT scan reveals pleural nodularity and an irregular-shaped subpleural mass in the left upper lobe.

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  Figure 3 Chest CT scan shows multiple enlarged lymph nodes in the left hilum and both paratracheal areas.

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  Figure 4 Histopathologic findings reveal poorly differentiated adenocarcinoma (A: H&E stain, ×100, B: H&E stain, ×400).

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