DOI: 10.12890/2026_006756

Slipping rib syndrome presenting as postprandial nausea: a diagnostic challenge in internal medicine

Authors

  • Valentin Mihail Botusanu Department of Internal Medicine, Kantonsspital Winterthur, Winterthur, Switzerland 0009-0004-8368-8505
  • Catalina Ioana Ursu Department of Pathology, Pathologie Medica Enge AG, Zürich, Switzerland 0009-0001-1852-7738

valentin.botusanu@yahoo.com

Keywords

Slipping rib syndrome, postprandial nausea, thoracoabdominal pain, diagnostic delay, musculoskeletal disorder

Abstract

Slipping rib syndrome is an under-recognised cause of thoracoabdominal pain that may present with atypical symptoms, leading to diagnostic delay. We report the case of a 23-year-old woman who presented with severe postprandial nausea as her dominant symptom, accompanied by episodic vomiting and unintentional weight loss. Extensive gastrointestinal and spinal investigations were unrevealing, and symptoms were subsequently interpreted as functional or psychosomatic. Careful clinical examination and targeted imaging ultimately identified slipping rib syndrome involving the eleventh right rib. Surgical resection of the mobile cartilaginous rib segment resulted in complete and sustained resolution of symptoms. This case highlights the importance of considering musculoskeletal causes in patients with unexplained gastrointestinal symptoms to avoid misdiagnosis and unnecessary investigations.

View the entire article

Downloads

References

  1. McMahon LE. Slipping Rib Syndrome: A review of evaluation, diagnosis and treatment. Semin Pediatr Surg 2018;27:183-188. doi: 10.1053/j.sempedsurg.2018.05.009
  2. Madeka I, Alaparthi S, Moreta M, Peterson S, Mojica JJ, Roedl J, et al. A Review of Slipping Rib Syndrome: Diagnostic and Treatment Updates to a Rare and Challenging Problem. J Clin Med 2023;12:7671. doi: 10.3390/jcm12247671
  3. Heinz GJ, Zavala DC. Slipping Rib Syndrome: Diagnosis Using the “Hooking Maneuver”. JAMA 1977;237:794–795. doi: 10.1001/jama.1977.03270350054023
  4. Sorensen CJ, DeSanto K, Borgelt L, Phillips KT, Monte AA. Cannabinoid hyperemesis syndrome: diagnosis, pathophysiology, and treatment—a systematic review. J Med Toxicol 2017;13:71–87. doi:10.1007/s13181-016-0595-z
  5. Van Tassel D, McMahon LE, Riemann M, Wong K, Barnes CE. Dynamic ultrasound in the evaluation of patients with suspected slipping rib syndrome. Skeletal Radiol 2019;48:741–751. doi: 10.1007/s00256-018-3133-z
  6. Mazzella A, Fournel L, Bobbio A, Janet-Vendroux A, Lococo F, Hamelin EC, et al. Costal cartilage resection for the treatment of slipping rib syndrome (Cyriax syndrome) in adults. J Thorac Dis 2020;12:10–16. doi: 10.21037/jtd.2019.07.83

Published

2026-05-11

Issue

Vol. 13 No. 6 (2026)

Categories

How to Cite

1.
Botusanu VM, Ursu CI. Slipping rib syndrome presenting as postprandial nausea: a diagnostic challenge in internal medicine. EJCRIM [Internet]. 2026 May 11 [cited 2026 Nov. 3];13(6). Available from: https://ejcrim.com/index.php/ejcrim/article/view/6756