Intractable hiccup: an odd complication after laparoscopic fundoplication for gastroesophageal reflux disease

Surg Endosc. 2002 Jul;16(7):1109. doi: 10.1007/s00464-001-4248-0. Epub 2002 Apr 9.


Intractable hiccup can be an unbearable circumstance and its treatment is often frustrating. More than 100 causes for hiccup have been described in the literature; the most common cause is gastroesophageal reflux disease (GERD). We report a case of a 31-year-old patient who suffered from intractable hiccup starting 3 weeks after laparoscopic Nissen fundoplication for GERD, a potential surgical complication that has not been described. After frustrating medical treatment, the patient underwent computed tomography and nerve stimulator-guided blockade of vagal and phrenic nerves on each side separately. Hiccup ceased only after blockade of the right phrenic nerve with 4 ml/h l% ropivacaine and relapsed soon after discontinuation. He underwent thoracoscopic right phrenicectomy, which rendered him symptom free for well over 2 months, at the time of this writing.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Fundoplication / adverse effects*
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / surgery*
  • Hiccup / drug therapy
  • Hiccup / etiology*
  • Hiccup / surgery*
  • Humans
  • Laparoscopy / adverse effects*
  • Male
  • Nerve Block
  • Phrenic Nerve / drug effects
  • Phrenic Nerve / surgery
  • Postoperative Complications / drug therapy
  • Postoperative Complications / etiology*
  • Postoperative Complications / surgery
  • Recurrence
  • Vagus Nerve / drug effects