Division of Gastroenterology, Department of Internal Medicine, Tung's Taichung Metroharbor Hospital, Taichung, Taiwan, R.O.C.
J Chin Med Assoc. 2010 Dec;73(12):647-50. doi: 10.1016/S1726-4901(10)70141-6.
Common causes of hiccups are over-distension of the stomach, a sudden change in gastrointestinal temperature, excessive alcohol and tobacco ingestion, and sudden excitement or emotional changes. Common presenting symptoms of sarcoidosis include cough, dyspnea, and chest pain. It is very rare for a sarcoidosis patient to present with hiccups. A 48-year-old man presented with hiccups of 2 weeks' duration. He denied having headaches, earache, cough, abdominal pain, fever, or body weight loss history. On physical examination, he had no peripheral lymphadenopathies in the neck, axilla and inguinal regions, no organomegaly in the abdomen and no skin abnormalities. A neurological examination showed normal findings. Laboratory investigations revealed a normal complete blood count, liver function, renal function, serum calcium, and tumor markers. Transabdominal ultrasound was negative, and panendoscopy revealed a small healing duodenal ulcer. Chest radiography showed an enlarged right lung hilum, while computed tomography showed enlargement of multiple mediastinal lymph nodes. Endoscopic ultrasound-guided fine-needle aspiration with a 22-gauge needle and trucut biopsy with a 19-gauge needle (quick-core biopsy needle) were performed, and cytology, cell block and histology revealed non-caseating granuloma, with negative tuberculous and fungus cultures. Mediastinal lymph node due to sarcoidosis can be a rare cause of hiccups.
打嗝的常见原因包括胃过度扩张、胃肠道温度突然变化、过量饮酒和吸烟以及突然兴奋或情绪变化。类肉瘤病的常见表现症状包括咳嗽、呼吸困难和胸痛。类肉瘤病患者出现打嗝的情况非常罕见。一名 48 岁男性因打嗝持续 2 周就诊。他否认有头痛、耳痛、咳嗽、腹痛、发热或体重减轻病史。体格检查时，他颈部、腋窝和腹股沟无外周淋巴结肿大，腹部无肝脾肿大，皮肤无异常。神经系统检查未见异常。实验室检查显示全血细胞计数、肝功能、肾功能、血清钙和肿瘤标志物均正常。腹部超声检查阴性，全内镜检查显示十二指肠小溃疡愈合。胸部 X 线检查显示右肺门增大，计算机断层扫描显示纵隔多个淋巴结肿大。进行了内镜超声引导下 22 号针细针抽吸和 19 号针（快速核心活检针）切取活检，细胞学、细胞块和组织学显示非干酪性肉芽肿，结核和真菌培养均为阴性。纵隔淋巴结的类肉瘤病可能是打嗝的罕见原因。
