Paraesophageal Hernia as a Cause of Chronic Asymptomatic Anemia in a 6 Years Old Boy; Case Report and Review of the Literature

Abstract

A B ST R AC T Esophageal hiatal hernia is defined as the prolapse of one or more intra-abdominal organs through the esophageal hiatus. Four types are identified: type Ι or sliding hiatal hernia, type II or paraesophageal hernia (PEH), type III or mixed hernia and type IV. Congenital type II esophageal hiatal hernia is caused by a remaining gap after the formation of pleuroperitoneal membrane. We present a case of a six years old boy admitted to our department, appearing with asymptomatic anemia, who was incidentally diagnosed with Type II esophageal hiatal hernia. After diagnostic investigation, the prolapsing stomach pouch was reduced, the hernia sac was excised, the crura of diaphragm were converged and a total fundoplication was performed, via open method. The patient had an uncomplicated postoperative period. We conclude that: 1) esophageal hiatal hernia should be included within diagnostic approach of a child with chronic non-hereditary anemia, 2) after a Type II esophageal hiatal hernia is diagnosed, a hernia repair surgery is indicated in short time, due to the severity of possible complications and 3) through the performance of total fundoplication, it is secured that the subdiaphragmatic abdominal part of esophagus will be retained, preventing the development of post-operative gastroesophageal reflux disease.

Late presentation of congenital type IV esophageal hiatus hernia in a 9-year-old boy: a case report

“…The differential diagnosis of intrathoracic cystic mass should include esophageal duplication cyst, hiatal hernia, pericardial cyst, macrocytic adenomatoid malformation, and neurenteric cyst [ 11 ]. As for our patient, initially, two differential diagnoses were made, including lung abscess and hydatid cyst (considering the endemic prevalence).…”

Giant hiatal hernia with intrathoracic spleen: A case report

“…The diagnosis of hiatal hernia can be quite challenging at times due to the change in the anatomy of the esophagogastric union during deglutition, respiration and movement [9] . To direct the diagnosis, 1 should integrate a complete clinical history and, in case of clinically suspicious conditoins, extend contrasted studies such as barium swallow and esophagogastricoduodenal studies, which continue to be current for the characterization of said pathology, and some authors consider it essential for the evaluation of the path of the alimentary bolus.…”

The management of hiatal hernia: an update on diagnosis and treatment

“…The incidence of symptomatic cases of hiatal hernia appears to be linked to the diagnosis of gastroesophageal reflux disease (GERD), the 2 conditions being closely associated [7,8]. The most characteristic manifestation one will find in hiatal hernia is gastroesophageal reflux, manifested through regurgitation and heartburn, while less common symptoms include dysphagia, epigastric or chest pain and even chronic iron deficiency anemia [5,9,10]. Large hernias can present with dysphagia, early satiety or regurgitation [6].…”