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A Child With Iron-Refractory Iron Deficiency Anemia: A Rare Case Associated With Hiatal Hernia

Worku Ketema1, Kefyalew Taye Garie1, Enatnesh Terefe Mame1

  • 1Department of Pediatrics and Child Health Hawassa University Hawassa Ethiopia.

Clinical Case Reports
|March 9, 2026
PubMed

Insights

Hiatal hernia can cause iron refractory iron deficiency anemia (IDA) in children. Surgical repair of the hernia resolved IDA in a young patient, highlighting a rare but important cause of anemia.

Area of Science:

  • Pediatric Hematology
  • Gastroenterology
  • Surgical Case Report

Background:

  • Iron deficiency anemia (IDA) is a prevalent pediatric health issue.
  • Gastrointestinal blood loss is a common cause of IDA in children.
  • Hiatal hernia is a rare cause of chronic gastrointestinal bleeding and iron refractory IDA.

Purpose of the Study:

  • To report a case of iron refractory IDA caused by a hiatal hernia in a child.
  • To highlight the importance of considering hiatal hernia in pediatric patients with refractory anemia.

Main Methods:

  • Case presentation of a 4-year-old male with iron refractory IDA.
  • Incidental finding of a hiatal hernia on chest CT scan during pneumonia evaluation.
  • Surgical repair of the hiatal hernia.

Main Results:

  • The patient's iron refractory IDA resolved after surgical repair of the hiatal hernia.
  • Hemoglobin levels normalized with iron supplementation post-surgery.
  • Follow-up complete blood counts at 2 and 6 months confirmed sustained recovery.

Conclusions:

  • Hiatal hernia is a rare but significant cause of iron refractory IDA in children.
  • Diagnosis and surgical management of hiatal hernia can effectively treat associated anemia.
  • Clinicians should consider hiatal hernia in the differential diagnosis of pediatric iron refractory IDA.

Keywords:
childhiatal herniairon deficiency anaemiairon‐refractory iron deficiency anaemia

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