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Europa Medicophysica 2001 June;37(2):125-7

Copyright © 2001 EDIZIONI MINERVA MEDICA

language: English

Respiratory complications of gastro-oesophageal reflux disease in a tetraplegic patient

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


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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.

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