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Rare disease
Intractable positional borborygmi – an unusual cause diagnosed by barium contrast study
  1. Abhishek Sharma1,
  2. Kieran Moriarty1,
  3. Hugh Burnett2,
  4. Marius Paraoan3,
  5. David Thompson2
  1. 1Department of Gastroenterology, Royal Bolton Hospital, Bolton, UK
  2. 2Department of Radiology, Salford Royal Foundation Trust, Salford, UK
  3. 3Department of General Surgery, Wrightington, Wigan & Leigh NHS Trust, Wigan, UK
  1. Correspondence to Abhishek Sharma, abisharma{at}


The authors report the case of a 48-year-old woman, with a 2-year history of prominent borborygmi, nausea, abdominal discomfort after large meals and weight loss. Continuous, prominent, audible borborygmi were evident while the patient remained standing. However, these noises abated when she held her breath or when pressure was applied over the left hypochondrium. When lying flat, abdominal examination was normal. Gastroscopy, colonoscopy, small bowel follow-through, abdominal CT scan, small bowel transit study and laparoscopy were all normal. A barium meal showed that her stomach was normal when lying flat, but adopted an hourglass deformity in the sitting position due to compression from her left anterior ribs. Compression from the diaphragm, on inspiration, then resulted in audible borborygmi.

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  • Competing interests None.

  • Patient consent Obtained.