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Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
Online ISSN 1973-9095
Delneri C., Cappellaro P., Visentini R., Rosin C., Saccavini M., Bizzarini E., Gottardo R., Onorato A., Zampa A.
From the Spinal Unit, Physical Medicine and Rehabilitation Hospital Udine, Italy
We report on a 73 year old male tetraplegic patient with respiratory complication of gastro-oesophageal reflux disease (GERD) and autonomic dysreflexia as a possibly linked mechanism. Spinal cord injury (SCI) had occurred 2 months previously leading to incomplete tetraplegia at C6 level (ASIA impairment scale “C”). The patient had a 5 year history of episodes of retrosternal pyrosis, acid regurgitation, nausea and sialorrhea. During hospitalization he had attacks of dyspnoea and choking accompanied by respiratory arrest. Initially, the cause of the respiratory attacks was unrecognised. He underwent twenty-four-hour oesophageal pH monitoring and oesophageal manometry: the former showed there were frequent gastro-oesophageal refluxes, and the latter revealed a hypotonic lower oesophageal sphincter with alterations in the peristalsis. The respiratory crises disappeared following antireflux treatment, dietary advice and changes to his life style.