Anaemia and hiatus hernia: experience in 450 patients.

Windsor, C. W. O.; Collis, J. Leigh

doi:10.1136/thx.22.1.73

Cited by 69 publications

(32 citation statements)

References 20 publications

(15 reference statements)

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“…For example, in 5 patients who underwent surgery for complications of hiatal hernial ulceration, radiological healing was observed within 17 days of operation in 4 patients, while in a fifth patient autopsy 14 days after operation revealed no visible evidence of ulceration.5 Similarly, in several other studies surgical treatment of hiatal hernia has abolished chronic blood loss, which in many cases was attributable to hiatal hernial ulceration. 1,6,12,19,20 Hiatal hernial ulcers do not appear to be a manifestation of severe peptic ulcer disease, since the prevalence of ulceration outwith the hiatal hernia (that is, duodenal ulcer or benign gastric copyright. ulcer) was similar (4 to 6%) to that expected in the general population and also similar to that observed in patients who had large hiatal herniae without hernial ulceration (10%).3 Mechanical factors, rather than luminal aggressive factors, appear to predominate in the pathogenesis ofhiatal hernial ulcers, as indicated by their site, poor therapeutic response to antisecretory drugs, and the good results of surgical restoration of the normal anatomical relationships of the stomach.…”

Section: Resultsmentioning

confidence: 99%

Hiatal hernial ulcers: clinical features and follow-up

Boyd

Penston

Russell

et al. 1991

Postgraduate Medical Journal

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Summary:We describe the clinical features and therapeutic outcome in 49 patients in whom benign gastric ulceration of an hiatal hernia was demonstrated endoscopicaily. Hiatal hernial ulcers accounted for 10% of all benign gastric ulcers. The typical patient was an elderly female with a history of dyspepsia who was receiving non-steroidal anti-inflammatory drugs. Twenty-seven (55%) patients had evidence of haemorrhage (acute in 15; chronic in 12) from the hiatal hernial ulcer at presentation. In 16 (33%) patients, symptoms attributable to haemorrhage constituted the sole clinical evidence of the hiatal hernial ulcer. Acute haemorrhage from hiatal hernial ulcers was associated with non-steroidal anti-inflammatory drug (NSAID) treatment (P < 0.05). Chronic blood loss from hiatal hernial ulcers was associated with female gender (P < 0.005) but not with NSAID treatment.Hiatal hernial ulcers healed slowly in response to medical treatment with H2-receptor antagonists (median time to healing 12 weeks). Surgical treatment may be the therapy of choice for hiatal hernial ulcers because of the high complication rate, poor response to medical therapy, and the apparent predominance of mechanical aetiological factors.

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Section: Resultsmentioning

confidence: 99%

Hiatal hernial ulcers: clinical features and follow-up

Boyd

Penston

Russell

et al. 1991

Postgraduate Medical Journal

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“…This study confirmed the findings of others that IDA could retard growth and development in children, and also reaffirmed that gastrointestinal tract blood loss and H. pylori infections are common causes of IDA. As reported by others, hiatus hernia was the underlying etiology of IDA in one of our patients [33][34][35][36]. Although the recommended daily requirements of iron are very small, IDA due to ineffective dietary intake was noted in our patients, explaining that most of them were from rural community.…”

Section: Discussionmentioning

confidence: 58%

Splenomegaly in Patients With Sideropenic Anemias: Clinical and Hematologic Significance

Khaled¹,

Seifeldein²

2016

J Hematol

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Background: Sideropenic anemias (SAs) are a group of hypoproliferative anemias characterized by hyposideremia. Although they run an insidiously started slowly progressive course, they are a pointer for an underlying serious disease. Fortunately, in most cases, management of SAs is available, effective and relatively inexpensive. Splenomegaly was reported in patients with SAs with variation in Hacckett's grading and hematological profile. Etiopathogenesis of splenomegaly in SAs was mainly explained as related to the underlying pathologic process of anemia or as a component of the rarely occurring PatersonKelly syndrome. Apart from these, etiopathogenesis of splenomegaly in SAs is still a fruitful point for current research. The aim of the present study was to assess splenomegaly in patients with SAs in terms of frequency, clinical and hematological profile of splenomegaly in SAs. Another aim was to assess prognostic significance and assume etiopathogenesis of splenomegaly in SAs.

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“…12 This mechanical abnormality may explain some cases of lesser-curvature ulceration in patients with hiatal hernias that have not been surgically repaired. 18 Laparoscopic surgery is now widely accepted as a 3,4 Our case suggests that gastric ulceration with subsequent gastropericardial fistula can be a late complication of laparoscopic Nissen fundoplication. The anatomical location of the ulcer, the findings at surgery, and the clinical presentation in this case parallel those associated with latent ulceration after open Nissen fundoplication.…”

Section: Discussionmentioning

confidence: 83%

Gastropericardial Fistula after Laparoscopic Surgery for Reflux Disease

2002

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APAROSCOPIC approaches are now commonly used to treat gastroesophageal reflux disease. 1,2 Many studies have demonstrated the safety, efficacy, and durability of these minimal-access procedures. 3 However, the learning curve for performing laparoscopic surgery in patients with reflux disease is steep, 4 and intraoperative complications can be life-threatening. 3 Reviews of long-term complications have shown that failed repairs (a "slipped wrap" or paraesophageal or hiatal hernia) can cause substantial morbidity. 3,5 We report a case in which a lifethreatening, gastropericardial fistula was a late complication of a laparoscopic Nissen procedure. CASE REPORTA 70-year-old man who was visiting Boston came to the emergency room in January 1998 with pain in his left shoulder that radiated to his neck. The hematocrit was 16 percent. His medical history included symptomatic gastroesophageal reflux that was refractory to medical therapy and prostate cancer, which had been treated with local radiation therapy two years earlier.In December 1996, the patient had undergone a laparoscopic Nissen fundoplication, with resolution of his reflux symptoms. The surgery was performed with a five-trocar technique. The stomach was easily reduced into the abdomen from the hiatal hernia. The short gastric arteries were divided. The right and left diaphragmatic crura were not closed behind the wrap. A complete fundal wrap of the intraabdominal esophagus was performed around an intraluminal bougie. Two nonabsorbable, nonpledgeted sutures secured the posterior portion of the wrap, the esophagus, and the anterior portion of the wrap. The wrap was not secured to the undersurface of the diaphragm.Several months after the surgery, atrial fibrillation and congestive heart failure developed. The atrial fibrillation converted to sinus rhythm with medical therapy. On Thanksgiving Day, 1997, the patient had sudden, severe abdominal pain, which abated after a drenching sweat. Although he did not have additional episodes of severe pain, he had chronic postprandial pain. He lost 9 kg in weight, had intermittent fevers, with temperatures as high as 39.4°C, and had nocturnal sweats.

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Anaemia and hiatus hernia: experience in 450 patients.

Cited by 69 publications

References 20 publications

Hiatal hernial ulcers: clinical features and follow-up

Hiatal hernial ulcers: clinical features and follow-up

Splenomegaly in Patients With Sideropenic Anemias: Clinical and Hematologic Significance

Gastropericardial Fistula after Laparoscopic Surgery for Reflux Disease

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