Surgical management of pathological aerophagia – a case report

Aerophagia, excessive air swallowing, is a rare clinical condition usually associated with neurologically abnormal children. A case of a 5-year-old Caucasian male, who presented with an acute surgical abdomen and worsening symptoms of abdominal pain and increasing abdominal distension, is discussed. Symptoms failed to resolve with conservative management therefore an exploratory laparotomy was performed but revealed no pathological cause. At follow-up the child was noted to be air swallowing using a plastic straw and he was subsequently diagnosed with pathological aerophagia. Five previous cases of aerophagia requiring surgical intervention have been published in the literature. Interestingly, the majority of these children were neurological normal. Aerophagia is an important differential diagnosis to consider in children presenting with worsening abdominal distension and the key to diagnosis is observation in order to identify the air swallowing behaviour.