title: [Pathologic aerophagia: a rare cause of chronic abdominal distension].
abstract: OBJECTIVE
  To describe an adolescent with pathologic aerophagia, a rare condition caused by excessive and inappropriate swallowing of air and to review its treatment and differential diagnoses.
  
  
  METHODS
  An 11 year-old mentally impaired blind girl presenting serious behavior problems and severe developmental delay with abdominal distension from the last 8 months. Her past history included a Nissen fundoplication. Abdominal CT and abdominal radiographs showed diffuse gas distension of the small bowel and colon. Hirschsprung's disease was excluded. The distention was minimal at the moment the child awoke and maximal at evening, and persisted after control of constipation. Audible repetitive and frequent movements of air swallowing were observed. The diagnosis of pathologic aerophagia associated to obsessive compulsive disorder and developmental delay was made, but pharmacological treatment was unsuccessful. The patient was submitted to an endoscopic gastrostomy, permanently opened and elevated relative to the stomach. The distention was resolved, while maintaining oral nutrition
  
  
  CONCLUSIONS
  Pathologic aerophagia is a rare self-limiting condition in normal children exposed to high levels of stress and may be a persisting problem in children with psychiatric or neurologic disease. In this last group, the disease may cause serious complications. Pharmacological and behavioral treatments are ill-defined. Severe cases may demand surgical strategies, mainly decompressive gastrostomy.
authors.affiliation: Universidade Federal Fluminense (UFF), Niterói, RJ, Brasil. Electronic address: lisieux@uol.com.br.
authors.forename: Lisieux Eyer
authors.initials: LE
authors.lastname: de Jesus
authors.affiliation: Universidade Federal Fluminense (UFF), Niterói, RJ, Brasil.
authors.forename: Ana Beatriz C S S
authors.initials: AB
authors.lastname: Cestari
authors.affiliation: Universidade Federal Fluminense (UFF), Niterói, RJ, Brasil.
authors.forename: Orli Carvalho da Silva
authors.initials: OC
authors.lastname: Filho
authors.affiliation: Universidade Federal Fluminense (UFF), Niterói, RJ, Brasil.
authors.forename: Marcia Antunes
authors.initials: MA
authors.lastname: Fernandes
authors.affiliation: Universidade Federal Fluminense (UFF), Niterói, RJ, Brasil.
authors.forename: Livia Honorato
authors.initials: LH
authors.lastname: Firme
mesh_terms: D000005:Abdomen / Q000473:pathology*; D000334:Aerophagy / Q000150:complications*; D002648:Child; D002908:Chronic Disease; D004108:Dilatation, Pathologic / Q000209:etiology; D005260:Female; D006801:Humans
keywords: Aerofagia; Aerophagy; Distensão patológica; Esvaziamento gástrico; Gastric emptying; Pathologic dilatation