Aerofagia patológica: uma causa rara de distensão abdominal crônica

Jesus, Lisieux Eyer de; Cestari, Ana Beatriz C.S.S.; Filho, Orli Carvalho da Silva; Fernandes, Marcia Antunes; Firme, Livia Honorato

doi:10.1016/j.rpped.2015.01.003

Cited by 6 publications

(1 citation statement)

References 12 publications

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“…Aerophagia was de ned as diffuse gastric, small bowel and colonic distension without signs of obstruction with uncomfortable gastrointestinal symptoms, such as abdominal distension, bloating, belching, and atulence 20 . This nding could be caused by excessive and repetitive air swallowing, particularly during non-invasive positive pressure ventilation (NPPV), by imbalances in supportive inspiratory and spontaneous expiratory phases 21 .…”

Section: Bowel Factormentioning

confidence: 99%

Diagnostic Yield of Chilaiditi’s Sign in Advanced-Phase Late-Onset Pompe Disease

Takahashi

Mori‐Yoshimura

Ariga

et al. 2021

Preprint

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Purpose: Chilaiditi’s sign (CS), hepatodiaphragmatic interposition of the intestine, was caused by morphological abnormalities such as diaphragmatic atrophy, intestinal dilation, and liver atrophy. The sign is potentially important due to associations with clinically recurrent abdominal pain or even colonic volvulus. In general, neuromuscular disease (NMD) could have the high prevalence of CS because of widened hepatodiaphragmatic space, following diaphragmatic atrophy. Particularly, in late-onset Pompe disease (LOPD), glycogen accumulation in smooth muscle of intestine could lead to the abnormal dilation of intestine. Though the prevalence of CS in LOPD could be high because of developing two main factors of CS, no studies have evaluated the prevalence of CS in LOPD. Our aim was to investigate the prevalence of CS in LOPD, and to identify the risk factors of CS in LOPD patients. Methods: Medical records of genetically confirmed patients of Pompe disease at the National Center Hospital, National Center of Neurology and Psychiatry were retrospectively reviewed. We evaluated CS using chest X-ray (CXR) and abdominal CT and assessed the prevalence of CS in LOPD patients. We also divided the patients into two groups, CS and non-CS group, and evaluated the factor associated with CS compared to clinical variables between groups. Results: Three of seven (43%) were detected in CS. CS group (P5-7) and non-CS group (P1-4) were obtained. In comparison of clinical variables, the severity of atrophy in right diaphragms was significantly higher in CS than non-CS groups (p =0.029). Also, the frequency of abnormal position of right diaphragm and liver, and abnormally dilated bowel was seen in all of CS patients, but none of non-CS patient (p = 0.029, each). Conclusion: In LOPD patients, the prevalence of CS was much higher of 43%, compared to healthy groups, or even in similarly respiratory muscle impaired neuromuscular diseases such as Duchenne muscular dystrophy (DMD) or Myotonic dystrophy type 1 (DM1). The anatomically abnormal position of diaphragm and liver, atrophy and fat infiltration of diaphragms, and abnormally dilated bowel were significantly associated with CS in LOPD. Since CS can cause intestinal symptoms or even contribute to sudden-death of intestinal volvulus, we should pay more attention to CXR or abdominal CT as follow up in LOPD patients.

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Section: Bowel Factormentioning

confidence: 99%

Diagnostic Yield of Chilaiditi’s Sign in Advanced-Phase Late-Onset Pompe Disease

Takahashi

Mori‐Yoshimura

Ariga

et al. 2021

Preprint

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The Abdomen

El-Radhi

2021

In Clinical Practice

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Pathologic aerophagia: a rare but important medical condition in people with intellectual disabilities

Wong

Sajith

2016

Brit J Learn Disabil

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Accessible Summary• Pathologic aerophagia is a rare but important medical condition that occur more frequently in people with intellectual disabilities.• It is characterised by repeated air swallowing resulting in progressive abdominal distension and flatulence, and sometimes it can cause serious and life-threatening complications.• Here, we present a literature on diagnosis and management of pathologic aerophagia and describe presentation of this condition in a 23-year-old male diagnosed with severe intellectual disability and autism. AbstractBackground: Pathologic aerophagia (PA) is characterised by excessive swallowing of air resulting in significant abdominal distension or belching. This is a relatively rare condition in general population but has been reported in up to 8.8% of institutionalised patients with intellectual disability. In severe cases, this can cause volvulus and ileus, and even intestinal perforation. Currently, there is limited information on this potentially life-threatening condition, particularly for people with intellectual disability. In this study, we aim to present a literature of diagnosis and management of PA and describe a case of PA in an adult with intellectual disability and autism. Methods: A literature search of electronic database was performed using specific keywords.Results: Apart from a few small controlled trials on pharmacotherapy, most of the studies were case series or uncontrolled studies. The understanding on pathophysiology is incomplete but is thought to involve a reflex-induced movement of upper oesophageal sphincter and may be associated with anxiety or stress. A comprehensive history and physical examination as well as an abdominal radiograph may be helpful in diagnosis. Medications that are helpful include antacids, anti-reflux drugs and benzodiazepines. Surgical treatment may be required in severe cases. A case of an adult patient with intellectual disability and PA is discussed to highlight the challenges in diagnosis and management.Conclusions: PA is not uncommon in people with intellectual disability and can pose challenges in the assessment and management. Further studies are necessary to ª The Official Journal of the British Institute of Learning Disabilities provide evidence-based treatment guidelines for the management of this condition particularly in patients with intellectual disability.

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Aerofagia patológica: uma causa rara de distensão abdominal crônica

Cited by 6 publications

References 12 publications

Diagnostic Yield of Chilaiditi’s Sign in Advanced-Phase Late-Onset Pompe Disease

Diagnostic Yield of Chilaiditi’s Sign in Advanced-Phase Late-Onset Pompe Disease

The Abdomen

Pathologic aerophagia: a rare but important medical condition in people with intellectual disabilities

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