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Case report
Unusual cause of severe iron deficiency anaemia in a child: paraoesophageal hernia
  1. Rishi Bolia1,
  2. Yash Srivastava2,
  3. Renu Yadav1 and
  4. Poonam Sherwani3
  1. 1Pediatric Gastroenterology, AIIMS Rishikesh, Rishikesh, Uttarakhand, India
  2. 2Pediatrics, AIIMS Rishikesh, Rishikesh, Uttarakhand, India
  3. 3Radiodiagnosis, AIIMS Rishikesh, Rishikesh, Uttarakhand, India
  1. Correspondence to Dr Rishi Bolia; rishibolia{at}yahoo.co.in

Abstract

Iron deficiency anaemia is a known complication of a large hiatal hernia in adults. It occurs as a result of erosions on the gastric mucosa secondary to traction at the hiatus during respiration and/or gastric acid-related injuries to the mucosa. Even though anaemia occurs as a result of chronic gastrointestinal blood loss, testing for faecal occult blood is often negative and upper gastrointestinal endoscopy normal as the bleeding is intermittent. In children, a hiatus hernia as a rare cause of iron deficiency anaemia and has been described only in case reports. Here, we describe a 5-year-old boy who presented with severe transfusion-dependent iron deficiency anaemia caused by a paraoesophageal hernia. Surgical repair of the hiatus hernia led to complete resolution of anaemia. One should consider a hiatus hernia as a diagnostic possibility when evaluating a child with refractory iron deficiency anaemia.

  • paediatrics (drugs and medicines)
  • gastrointestinal system

https://doi.org/10.1136/bcr-2020-237728

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    Footnotes

    • Contributors RB: Data collection, drafting of the article, critical revision of the manuscript for important intellectual content, final approval of the version to be published. RY: Data collection, drafting of the article, critical revision of the manuscript for important intellectual content, approval of final version of the manuscript. PS: Data collection, critical revision of the manuscript for important intellectual content, final approval of the version to be published. YS: Critical revision of the manuscript for important intellectual content, approval of final version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Parental/guardian consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.