title: [Hiccup, a diagnostic challenge].
abstract: Hiccup is a spasmodic involuntary contraction of the diaphragm which triggers a sudden inspiration and an abrupt closure of the glottis with a characteristic sound. Regarding its duration, it is classified as hiccup attack, persistent hiccup or rebellious or intractable hiccup. We present the case of a 75 old male with rebellious hiccup which prevented him to fall asleep by day or by night, associated with belches lasting for three years, refractory to chlorpromazine. An extensive evaluation led to the diagnosis of right ethmoid sinus tumor. The tumor resection was performed and after subsequent local radiotherapy the hiccup disappeared. We consider this a rare cause of rebellious hiccup that generated a diagnostic and therapeutic challenge.
authors.affiliation: Servicio de Clínica Médica, Hospital Británico de Buenos Aires, Argentina.
authors.forename: Sonia
authors.initials: S
authors.lastname: Pankl
authors.forename: Mariano A
authors.initials: MA
authors.lastname: Quezel
authors.forename: Julio E
authors.initials: JE
authors.lastname: Bruetman
authors.forename: Bárbara C
authors.initials: BC
authors.lastname: Finn
authors.forename: Pablo
authors.initials: P
authors.lastname: Young
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications*; D005005:Ethmoid Sinus; D006606:Hiccup / Q000209:etiology*; D006801:Humans; D008297:Male; D010255:Paranasal Sinus Neoplasms / Q000150:complications*
keywords: hiccup; reflex arc
vernacular_title: Hipo, un desafío diagnóstico.