Intractable singultus: a case report

Abstract

Background: Intractable singultus is a rare disorder, and there are no guidelines for its management. More than 100 etiologies are described in the literature, but the etiology cannot be defined in as much as 20% of patients. Acute singultus needs no further treatment, but intractable singultus warrants thorough evaluation and treatment because it has high morbidity and mortality.Case Presentation: We present a 29-year-old male with intractable singultus accompanied by a sliding hiatal hernia, refractory to chlorpromazine and baclofen treatment, and hiatal hernia repair. The patient underwent hiatal hernia repair and Nissen fundoplication, which provided 3 days free of singultus. On the fourth postoperative day, the singultus begins 3 times a day, with episodes lasting up to 5 minutes, with a rate of 10-25 singultus per minute. The patient was discharged on postoperative day-5, hemodynamic was stable and no signs of infection were reported.Conclusion: Symptomatic treatment for intractable singultusis often unsuccessful, with serious side effects that may impair the patient's quality of life. The cornerstone of the management of intractable singultus is finding the etiology.