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Case Reports
. 2015 Jul-Sep;33(3):372-6.
doi: 10.1016/j.rpped.2015.01.003. Epub 2015 Jun 19.

[Pathologic aerophagia: a rare cause of chronic abdominal distension]

[Article in Portuguese]
Lisieux Eyer de Jesus  1 , Ana Beatriz C S S Cestari  2 , Orli Carvalho da Silva Filho  2 , Marcia Antunes Fernandes  2 , Livia Honorato Firme  2
Affiliations
Case Reports

[Pathologic aerophagia: a rare cause of chronic abdominal distension]

[Article in Portuguese]
Lisieux Eyer de Jesus et al. Rev Paul Pediatr. 2015 Jul-Sep.

Abstract

Objective:: To describe an adolescent with pathologic aerophagia, a rare condition caused by excessive and inappropriate swallowing of air and to review its treatment and differential diagnoses.

Case description:: An 11-year-old mentally impaired blind girl presenting serious behavior problems and severe developmental delay with abdominal distension from the last 8 months. Her past history included a Nissen fundoplication. Abdominal CT and abdominal radiographs showed diffuse gas distension of the small bowel and colon. Hirschsprung's disease was excluded. The distention was minimal at the moment the child awoke and maximal at evening, and persisted after control of constipation. Audible repetitive and frequent movements of air swallowing were observed. The diagnosis of pathologic aerophagia associated to obsessive-compulsive disorder and developmental delay was made, but pharmacological treatment was unsuccessful. The patient was submitted to an endoscopic gastrostomy, permanently opened and elevated relative to the stomach. The distention was resolved, while maintaining oral nutrition.

Comments:: Pathologic aerophagia is a rare self-limiting condition in normal children exposed to high levels of stress and may be a persisting problem in children with psychiatric or neurologic disease. In this last group, the disease may cause serious complications. Pharmacological and behavioral treatments are ill-defined. Severe cases may demand surgical strategies, mainly decompressive gastrostomy.

Keywords: Aerofagia; Aerophagy; Distensão patológica; Esvaziamento gástrico; Gastric emptying; Pathologic dilatation.

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Conflict of interest statement

Conflicts of interest

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1. Severe abdominal distension, causing limitation of thoracic expansion. Abdominal scar corresponds to previous gastrostomy site. Notice scarring on the hand, due to repetitive biting.
Figure 2
Figure 2. Diffuse and severe gas distension, attaining small intestine and colon.
Figura 1
Figura 1. Distensão abdominal grave, que causava limitação da expansão torácica. Cicatriz abdominal corresponde ao local da gastrostomia anterior. Observe as cicatrizes na mão, devido à mordedura de repetição.
Figura 2
Figura 2. Distensão abdominal causada por gases difusa e grave que atinge o intestino delgado e o cólon.
See this image and copyright information in PMC

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