[Cameron syndrome and iron deficiency anemia in hiatal hernias]

Hiatal hernia (HH) can cause iron deficiency anemia (IDA) development. In 5-10% patients with HH, the anemia syndrome is refractory to conservative ferrotherapy, which necessitates the antireflux surgery.

A prospective study includes 42 patients with verified HH and comorbid IDA who underwent fundoplication by the method of Petrovsky National Research Center of Surgery for the period from 2023 to 2024. A complex diagnostic algorithm including extensive laboratory testing with determination of red blood cells and ferrokinetic parameters was used in all patients. The effectiveness of intervention was assessed 6 and 12 months after surgery with analysis of clinical and laboratory parameters.

A complete regression of gastroesophageal reflux disease symptoms was achieved in 39 (92.8%) patients. Laboratory monitoring after 6 months demonstrated normalization of haemoglobin and serum iron levels in 35 (94.5%) of 37 examined patients. It is noteworthy that the preservation of normal haematological parameters was observed 12 months after the surgery despite the absence of additional ferrotherapy during the second half of the year that indicates a persistent clinical effect of the surgical treatment and the elimination of main anemia pathogenetic factor.

The obtained data confirm a high effectiveness of HH surgery in the treatment of refractory IDA associated with Cameron syndrome and emphasize the necessity of timely detection of this pathology to optimize treatment tactics for patients.