A large hiatal hernia with cameron ulcer presenting as refractory sever iron deficiency anemia: A case report

Abstract

Background: Hiatal hernia is an abnormal protrusion of the stomach into thoracic cavity via esophageal hiatus. The prevalence is reported as 0.8–5.2% in upper gastrointestinal endoscopy. Patients with large diaphragmatic hiatal hernia occasionally manifest as sever iron deficiency anemia. The etiology is chronic bleeding from a gastric ulcer where a hiatal hernia passes through a diaphragmatic hiatus. Case presentation: A 4-year-old female patient presented with easily fatigability, tinnitus, light headedness, epigastric abdominal pain, blacking of stool and geophagia of 1 year duration. She was transfused 03 times at different time at different hospital for congestive heart failure secondary to sever iron deficiency anemia while she was taking therapeutic iron therapy. The patient recovered completely after surgical repair of the hernia. Conclusion: Cameron ulcer is a rare cause of iron deficiency anemia from chronic blood loss. It is fatal but easily treatable ulcer at hiatal hernia. It very rare in pediatrics age particularly under five children and high index of suspicion is lifesaving. Keywords: Anemia, Cameron lesions, Cameron ulcer, Hiatal hernia