不同原因導致的復發性呃逆

Recurrent Hiccups of Different Etiologies in An Elderly Man

一位67 歲男性病患胃部不適，胃鏡檢查前心臟篩查無意間發現巨大心臟黏液瘤。他接受心臟黏液瘤切除術，而放棄胃鏡檢查。他在手術後出現持續性呃逆，被認為是術後縱膈血腫所致。中西醫保守治療共計 21 天後呃逆消失。一年後，持續性呃逆復發。鋇造影、胸部CT像和胃鏡檢查都顯示侵及食管和胃體的胃賁門癌。胃賁門癌根治術後，病人順利康復、呃逆消失。呃逆的不同病因的演變可能困擾醫生，其病因的確診對及早地給予正確的治療至關重要。

A 67-year-old male patient with gastric upset disclosed a huge cardiac myxoma incidentally in a cardiac screening examination before gastroscopy. He thus gave up the gastroscopy and received a cardiac myxoma resection. Following the operation, he developed persistent hiccups, which were considered to be a result of the postoperative mediastinal hematoma. The hiccups were cured after the completion of a 21-day treatment with integrated Western and traditional Chinese medicine. One year later, he developed recurrent intractable hiccups. Barium contrast radiography, chest computed tomography and gastroscopy all suggested a gastric cardiac tumor involving the esophagus and gastric body. He received radical resection of the gastric cardia carcinoma and recovered uneventfully, being free from intractable hiccups after the operation. The evolving different etiologies of a hiccup may perplex the physician and a definitive diagnosis can be imperative to ensure the correct treatment is offered.