Journal of clinical gastroenterology
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J. Clin. Gastroenterol. · Aug 1987
Review Case ReportsBarium appendicitis: fact or fancy? Report of a case and review of the literature.
Whether barium retained in the appendix can be a cause of acute appendicitis is debatable. We describe a 40-year-old man who developed nonspecific right abdominal pain 7 weeks after a barium enema, which proved to be normal. ⋯ Thus far, 26 cases of "barium appendicitis" have been reported. On the basis of the relevant literature and the cases collected, it is appropriate to draw the following conclusions: 1) With present knowledge it is not possible to state whether retained barium plays any etiologic role in the development of subsequent uncomplicated acute appendicitis. 2) If a later appendicitis does supervene, it carries a high risk of being complicated; barium seems to be responsible for the complication. 3) The longer the interval between the barium study and the subsequent appearance of acute appendicitis, the higher will be the risk of complications.
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Hiccups result from a wide variety of conditions that act on the supraspinal hiccup center or that stimulate or disinhibit the limbs of its reflex arc. While scores of hiccup remedies have been reported over the centuries, no single "cure" stands out as being the most effective. Measures that stimulate the uvula or pharynx or disrupt diaphragmatic (respiratory) rhythm are simple to use and often help to speed the end of a bout of otherwise benign, self-limited hiccups. ⋯ Drug therapy usually becomes necessary for more intractable hiccups; chlorpromazine and metoclopramide being two of the most widely employed agents for this purpose. Physical disruption of the phrenic nerve, hypnosis, and acupuncture are other modes of therapy that have been used in severe cases. Because so many reports of hiccup "cures" are based on anecdotal experience rather than controlled clinical studies, I review the available treatments to provide a rational approach for the management of hiccups.