Diferencia entre revisiones de «Hiccups»
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==Background==
==Background==
*Usually initiated by gastric distention from food, carbonated beverage, or air
*Usually initiated by gastric distention from food, carbonated beverage, or air
*Also known as Singultus  
*Also known as Singultus
 
 
===Definitions===
 
*Hiccup bout: <48 hours
*Persistent hiccups: 48 hours to 1 month
*Intractable hiccups: >1 month
 


==Clinical Features==
==Clinical Features==
*Hiccups
*Hiccups


==Differential Diagnosis==
==Differential Diagnosis==


==Diagnosis==
*Auditory canal exam (foreign body against TM can trigger hiccups)
*CXR


==Treatment ==
===Hiccups===
 
*Central nervous system disorders
**Vascular
***Ischemic/hemorrhagic [[Special:MyLanguage/stroke|stroke]]
***AV malformations
***[[Special:MyLanguage/Temporal arteritis|Temporal arteritis]]
**Infections
***[[Special:MyLanguage/Encephalitis|Encephalitis]]
***[[Special:MyLanguage/Meningitis|Meningitis]]
***[[Special:MyLanguage/Brain abscess|Brain abscess]]
***[[Special:MyLanguage/Neurosyphilis|Neurosyphilis]]
***Subphrenic abscess
**Structural
***[[Special:MyLanguage/Head trauma|Head trauma]]
***[[Special:MyLanguage/Intracranial neoplasm|Intracranial neoplasm]]
***Brainstem neoplasms
***[[Special:MyLanguage/Multiple sclerosis|Multiple sclerosis]]
***[[Special:MyLanguage/Syringomyelia|Syringomyelia]]
***[[Special:MyLanguage/Hydrocephalus|Hydrocephalus]]
**Vagus and phrenic nerve irritation
***[[Special:MyLanguage/thyroid disease|Goiter]]
***[[Special:MyLanguage/Pharyngitis|Pharyngitis]]
***[[Special:MyLanguage/Laryngitis|Laryngitis]]
***Hair or foreign body irritation of tympanic membrane
***Neck cyst or other tumor
*Gastrointestinal disorders
**Gastric distention
**[[Special:MyLanguage/Gastritis|Gastritis]]
**[[Special:MyLanguage/Peptic ulcer disease|Peptic ulcer disease]]
**[[Special:MyLanguage/Pancreatitis|Pancreatitis]]
**Pancreatic cancer
**Gastric carcinoma
**Abdominal abscesses
**[[Special:MyLanguage/Gallbladder disease|Gallbladder disease]]
**[[Special:MyLanguage/Inflammatory bowel disease|Inflammatory bowel disease]]
**[[Special:MyLanguage/Hepatitis|Hepatitis]]
**Aerophagia
**Esophageal distention
**[[Special:MyLanguage/Esophagitis|Esophagitis]]
**[[Special:MyLanguage/Bowel obstruction|Bowel obstruction]]
*Thoracic disorders
**Enlarged lymph nodes secondary to infection or neoplasm
**[[Special:MyLanguage/Pneumonia|Pneumonia]]
**[[Special:MyLanguage/Empyema|Empyema]]
**[[Special:MyLanguage/Bronchitis|Bronchitis]]
**[[Special:MyLanguage/Asthma|Asthma]]
**[[Special:MyLanguage/Pleuritis|Pleuritis]]
**[[Special:MyLanguage/Nontraumatic thoracic aortic dissection|Aortic dissection]]
**[[Special:MyLanguage/Mediastinitis|Mediastinitis]]
**Mediastinal tumors
**[[Special:MyLanguage/Chest trauma|Chest trauma]]
**[[Special:MyLanguage/Pulmonary embolism |Pulmonary embolism ]]
*Cardiovascular disorders
**[[Special:MyLanguage/Myocardial infarction|Myocardial infarction]]
**[[Special:MyLanguage/Pericarditis|Pericarditis]]
*Toxic-metabolic
**[[Special:MyLanguage/Alcohol intoxication|Alcohol intoxication]]
**[[Special:MyLanguage/Diabetes mellitus|Diabetes mellitus]]
**[[Special:MyLanguage/Herpes zoster|Herpes zoster]]
**[[Special:MyLanguage/Hypocalcemia|Hypocalcemia]]
**[[Special:MyLanguage/Hypocapnia|Hypocapnia]]
**[[Special:MyLanguage/Hyponatremia|Hyponatremia]]
**[[Special:MyLanguage/Influenza|Influenza]]
**[[Special:MyLanguage/Malaria|Malaria]]
**[[Special:MyLanguage/Tuberculosis|Tuberculosis]]
**[[Special:MyLanguage/Uremia|Uremia]]
*Postoperative
**General anesthesia
**[[Special:MyLanguage/Intubation|Intubation]] (stimulation of glottis)
**Neck extension (stretching phrenic nerve roots)
**Gastric distention
**Traction on viscera
*Drugs
**Alpha methyldopa
**Short-acting [[Special:MyLanguage/barbiturates|barbiturates]]
**Chemotherapeutic agents (eg, carboplatin)
**[[Special:MyLanguage/Dexamethasone|Dexamethasone]]
**[[Special:MyLanguage/Diazepam|Diazepam]]
*Psychogenic
**[[Special:MyLanguage/Anorexia nervosa|Anorexia nervosa]]
**[[Special:MyLanguage/Conversion reaction|Conversion reaction]]
**Excitement
**Malingering
**[[Special:MyLanguage/Schizophrenia|Schizophrenia]]
**Stress
 
 
==Evaluation==
 
*Clinical diagnosis
*Consider auditory canal exam (foreign body against TM can trigger hiccups)
*Consider [[Special:MyLanguage/Hyponatremia|Hyponatremia]] and [[Special:MyLanguage/Hypocalcemia|Hypocalcemia]]
*Consider [[Special:MyLanguage/CXR|CXR]]
 
 
==Management==
 
*Physical Maneuvers (stimulating pharynx blocks the vagal portion of the reflex arc)
*Physical Maneuvers (stimulating pharynx blocks the vagal portion of the reflex arc)
**Remove foreign body from ear
**Remove [[Special:MyLanguage/ear foreign body|foreign body]] from ear
**Swallow teaspoon of sugar
**Swallow teaspoon of sugar
**Sip ice water
**Sip ice water
**Drink water quickly
**Drink water quickly
*Meds
*Meds
**[[Chlorpromazine]] 25–50mg IV; 25–50mg PO TID  
**[[Special:MyLanguage/Chlorpromazine|Chlorpromazine]] 25–50mg IV; 25–50mg PO TID  
**[[Metoclopramide]] 10mg IV or IM; 10–20mg PO TID x 10d
**[[Special:MyLanguage/Metoclopramide|Metoclopramide]] 10mg IV or IM; 10–20mg PO TID x 10d
**Initiating pharmacologic treatment with a [[Special:MyLanguage/proton pump inhibitor|proton pump inhibitor]]. Alternative first-line agents include [[Special:MyLanguage/baclofen|baclofen]], [[Special:MyLanguage/gabapentin|gabapentin]], and [[Special:MyLanguage/metoclopramide|metoclopramide]]<ref>Lembo et al. Hiccups. Uptodate.https://www.uptodate.com/contents/hiccups?search=Hiccups&source=search_result&selectedTitle=1~41&usage_type=default&display_rank=1#H1014341651 </ref>
 
 
==Disposition==
 
*Discharge for uncomplicated hiccups
 


==See Also==
==See Also==


==References==
==References==
<references/>


[[Category:GI]]
[[Category:GI]]
[[category:Symptoms]]
</translate>

Revisión actual - 23:05 4 ene 2026


Background

  • Usually initiated by gastric distention from food, carbonated beverage, or air
  • Also known as Singultus


Definitions

  • Hiccup bout: <48 hours
  • Persistent hiccups: 48 hours to 1 month
  • Intractable hiccups: >1 month


Clinical Features

  • Hiccups


Differential Diagnosis

Hiccups


Evaluation

  • Clinical diagnosis
  • Consider auditory canal exam (foreign body against TM can trigger hiccups)
  • Consider Hyponatremia and Hypocalcemia
  • Consider CXR


Management


Disposition

  • Discharge for uncomplicated hiccups


See Also

References

  1. ↑ Lembo et al. Hiccups. Uptodate.https://www.uptodate.com/contents/hiccups?search=Hiccups&source=search_result&selectedTitle=1~41&usage_type=default&display_rank=1#H1014341651
Obtenido de «https://www.wikem.org/w/index.php?title=Hiccups&oldid=378999»