• T Strate, T E Langwieler, O Mann, W T Knoefel, and J R Izbicki.
• Department of Surgery, University Hospital Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany. strate@uke.uni-hamburg.de
• Surg Endosc. 2002 Jul 1; 16 (7): 1109.

AbstractIntractable 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.

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