The Journal of Thoracic and Cardiovascular Surgery, Vol 73, 497-503, Copyright © 1977 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Diagnosis and treatment of hemorrhage in patients with hiatal hernia
CW Deveney and AN Thomas
A retrospective study examined the clinical course of 32 patients with
hiatal hernia in whom hemorrhage of the upper gastrointestinal tract was a
prominent symptom. Hemorrhagic esophagitis was the most common source of
bleeding. Duodenal ulcer, gastritis, and gastric ulcer of the herniated
stomach were other less frequent causes of hemorrhage in these patients.
Hemorrhage from esophagitis is usually mild and chronically recurrent.
Surgical correction of the hiatal hernia and reflux is adequate treatment
for the patient with hemorrhage from esophagitis or gastritis of the
herniated stomach. Hemorrhage from duodenal ulcer as well as gastric ulcer
requires a procedure directed at these lesions. Because of the association
of upper gastrointestinal bleeding in hiatal hernia with lesions other than
esophagitis, a vigorous diagnostic approach with endoscopy is essential.
