A clinical case of severe iron deficiency anemia in a patient with hiatal hernia
https://doi.org/10.33667/2078-5631-2021-23-104-109
Abstract
Among the many reasons for the development of iron deficiency anemia, chronic blood loss from Cameron ulcers, developing with hiatal hernias, is gaining increasing clinical significance. Nevertheless, doctors of various specialties still have limited knowledge about the role of this pathology in the depletion of the iron depot, the specifics of instrumental verification of the diagnosis, and the possibilities of surgical technologies in the complex treatment of patients with this disease. The described case illustrates the long-term course of severe iron deficiency anemia in a patient with hiatal hernia (type III) due to latent blood loss from Cameron ulcers. The use of a therapeutic algorithm, which included complex conservative therapy followed by laparoscopic surgery to eliminate the hiatal hernia, led to a complete recovery of the patient.
About the Authors
D. V. Lukanin
Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Dmitriy V. Lukanin, MD, associate professor of the general surgery department
Moscow
A. A. Sokolov
Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Alexey A. Sokolov, DM Sci, professor of general surgery department
Moscow
A. A. Sokolov
Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Alexey A. Sokolov, assistant of the general surgery department
Moscow
M. S. Klimenko
Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Marina S. Klimenko, assistant of the general surgery department
Moscow
References
1. Goddard A. F., James M. W., McIntyre A. S., Scott B. B. Guidelines for the management of iron deficiency anaemia. Gut. 2011;60:13 09 -1316. doi: 10.1136/gut.2010.228874.
2. Cameron A. J., Higgins J. A. Linear gastric erosion. A lesion associated with large diaphragmatic hernia and chronic blood loss anemia. Gastroenterology. 1986;91:338-342.
3. Stein J., Connor S., Virgin G., Ong D. E., Pereyra L. Anemia and iron deficiency in gastrointestinal and liver conditions. World J Gastroenterol. 2016;22:7908-7925. doi: 10.3748/wjg.v22.135.7908
4. Panzuto F., Di Giulio E., Capurso G., Baccini F., D’Ambra G., Delle Fave G., Annibale B. Large hiatal hernia in patients with iron deficiency anaemia: a prospective study on prevalence and treatment. Aliment Pharmacol Ther. 2004;19:663-670. https://doi.org/10.1111/j.1365-2036.2004.01894.x
5. Chun C. L., Conti C. A., Triadafilopoulos G. Cameron ulcers: you will find only what you seek. Digestive Diseases and Sciences. 2011;56:3450-3452. doi: 10.1007/s10620-011-1803-y.
6. Gray D. M., Kushnir V., Kalra G., Rosenstock A. et al. Cameron lesions in patients with hiatal hernias: prevalence, presentation, and treatment outcome. DisEsophagus. 2015 Jul;28 (5): 448-52. https://doi.org/10.1111/dote.12223
7. Katz J., 6rar S., Sidhu J. S. Histopathological characterization of a Cameron lesion. Int J Surg Pathol. 2012;20(5):528-530. doi: 10.1177/1066896912446947.
8. Maganty K., Smith R. L. Cameron lesions: unusual cause of gastrointestinal bleeding and anemia. Digestion 2008;77:214-217. doi: 10.1159/000144281.
9. Skipworth R. J., Staerkle R. F., Leibman S., Smith G. S. Transfusion-Dependent Anaemia: An Overlooked Complication of Paraoesophageal Hernias. IntSch Res Notices. 2014;2014:479240. https://doi.org/10.1155/2014/479240
10. Ruhl C. E., Everhart J. E. Relationship of iron-deficiency anemia with esophagitis and hiatal hernia: hospital findings from a prospective, population-based study. Am J Gastroenterol. 2001;96:322-326. doi: 10.1111/j.1572-0241.2001.03513.х.
11. Pauwetyn K. A., Verhamme M. Large hiatal hernia and iron deficiency anaemia: clinico-endoscopical findings. Acta Clin 6elg. 2005;60: 166-172. doi: 10.1179/006.2005.030.
12. Nguyen N., Tam W., KimberR., Roberts-Thomson I. C. Gastrointestinal: Cameron’s erosions. J Gastroenterol Hepatol. 2002;17(3):343. DOI: 10.1046/].1440-1746.2002.02760x
13. Dietrich C. G., Hubner D., Heise J. W. Paraesophageal hernia and iron deficiency anemia: Mechanisms, diagnostics and therapy. World J Gastrointest Surg. 2021 Mar27;13(3):222-230. DOI: 10.1046/j.1440-1746.2002.02760.x
14. Carrott P. W., Markar S. R., Hong J., Kuppusamy M. K., Koehler R. P., Low D. E. Iron-deficiency anemia is a common presenting issue with giant paraesophageal hernia and resolves following repair. J Gastrointest Surg. 2013;17:858-862. DOI: 10.1046/j.1440-1746.2002.02760.x
15. Kohn Q. P., Price R. R., Demeester S. R., Zehetner J., Muensterer O. J., Awad Z. et al. Guidelines for the management of hiatal hernia. Surgical Endoscopy. 2013. Dec;27(12):4409-28. doi: 10.1007/S00464-013-3173-3.
16. Memon M. A. Hiatal hernia surgery an evidence based approach. Springer international publishing. Australia. 2018. 309 p. https://doi.org/10.1007/978-3-319-64003-7
17. Appleteard M. N., Swain C. P. Endoscopic difficulties in the diagnosis of upper gastrointestinal bleeding. World J Gastroenterol 2001;7:308-312. doi: 10.3748/wjg.v7.i3.308
18. Зедгенидзе Г. А. Клиническая рентгенорадиология. Т. 2. Рентгенодиагностика заболеваний органов пищеварения. М.: Медицина, 1983. 440 с. [Zedgenidze G. A. Klinicheskaya rentgenoradiologiya. T. 2. Rentgenodiagnostika zabolevanij organov pishchevareniya. M.: Medicina, 1983. 440 s.]
19. Сторожаков Г. И., Чукаева И. И., Александров А. А. Поликлиническая терапия. М., 2011. (2-е изд., перераб. и доп.). 636 с. [Storozhakov G. I., Chukaeva I. I., Alexandrov A. A. Poliklinicheskaya terapiya. - M., 2011. (2-e izd., pererab. i dop.). 636 s.]
20. Ko C. W., Siddique S. M., Patel A., Harris A., Sultan S., Altayar O., Falck-Ytter Y. AGA Clinical Practice Guidelines on the Gastrointestinal Evaluation of Iron Deficiency Anemia. Gastroenterology. 2020;159:1085-1094. doi: 10.1053/j.gastro.2020.06.046.
21. Gerson L. B., Fidler J. L., Cave D. R., Leighton J. A. ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding. Am J Gastroenterol. 2015;110:1265-87; quiz 1288. doi: 10.1038/ajg.2015.246.
22. De Leusse A., Landi B., Edery J., Burtin P., Lecomte T., Seksik P., Bloch F., Jian R., Cellier C. Video capsule endoscopy for investigation of obscure gastrointestinal bleeding: feasibility, results, and interobserver agreement. Endoscopy. 2005;37:617-521. doi: 10.1055/s-2005-861419.
23. Wilshire C. L., Louie B. E., Shultz D, Jutric Z, Farivar A. S., Aye R. W. Clinical Outcomes of Reoperation for Failed Antireflux Operations. Ann Thorac Surg. 2016 Apr;101(4):1290-6. doi:10.1016/j.athoracsur.2015.10.027.
24. Moschos J., Pilpilidis I., Kadis S., Antonopoulos Z., Paikos D., Tzilves D., Katsos I., Tarpagos A. Cameron lesion and its laparoscopic management. Indian J Gastroenterol 2005;24:163.
25. Yakut M., Soylan I., Kabacam G. Clinical Characteristics and Evaluation of Patients with Large Hiatal Hernia and Cameron Lesions. Southern. medical journal. 2011;104(3):179-184. doi: 10.1097/SMJ.0b013e31820c018c.
Review
For citations:
Lukanin D.V., Sokolov A.A., Sokolov A.A., Klimenko M.S. A clinical case of severe iron deficiency anemia in a patient with hiatal hernia. Medical alphabet. 2021;(23):104-109. (In Russ.) https://doi.org/10.33667/2078-5631-2021-23-104-109
Views:
1125
Email this article 