Pericardial cyst as a cause of recurrent hiccups: a case report
Bibliographic record
Abstract
Background: Pericardial cysts are an uncommon cause of mediastinal masses. When identified, they are often an incidental finding on imaging. However, when symptomatic, they may present with cough, dyspnea, recurrent pulmonary infections, chest pain, congestive heart failure, or dysphagia. In symptomatic cases, surgical treatment is typically warranted. We present a case where the sole symptom of presentation was recurrent hiccups, refractory to other treatments, that resolved after thoracoscopic resection. Case Description: A 51-year-old male presented to outpatient thoracic surgery clinic with a history of persistent, recurrent hiccups for 3 months. The patient’s past medical history was non-contributory. His hiccups persisted despite attempted medical therapy. On initial chest X-ray, an irregularity of the right heart border was seen. On chest computed tomography (CT), a simple fluid filled pericardial cyst was observed, in close proximity to the right phrenic nerve. The patient underwent a right video-assisted thoracoscopic removal of this pericardial cyst. Post-operatively, the patient recovered well, with complete resolution of hiccups prior to discharge on post-operative day one. No recurrence was seen during follow-up at 4 and 8 weeks. Conclusions: There are few existing cases of pericardial cysts presenting with hiccups, none of which have been approached with video-assisted thoracoscopic surgery (VATS), to our knowledge. In this case, we observed persistent hiccups as the sole symptom of presentation of a pericardial cyst. Upon surgical removal via a VATS approach, there was complete symptom dissipation. Pericardial cysts should be considered in the differential diagnosis of recurrent hiccups. If identified, surgical resection can result in complete cessation of symptoms.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.006 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".