Journal
JOURNAL OF GASTROINTESTINAL SURGERY
Volume 17, Issue 5, Pages 858-862Publisher
SPRINGER
DOI: 10.1007/s11605-013-2184-7
Keywords
Paraesophageal hernia; Anemia; Cameron's lesions; Paraesophageal hernia repair
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Funding
- Ryan Hill Research Foundation
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A significant percentage of patients with paraesophageal hernia (PEH) will have a co-existing diagnosis of iron-deficiency anemia which will resolve following surgical repair. Between 2000 and 2010, 270 patients underwent operative repair of PEH. Of this group, 123 patients (45.6 %) reported a preexisting diagnosis of iron-deficiency anemia. The study group consisted of 77 patients with a documented preoperative hemoglobin level (Hb) consistent with iron-deficiency anemia and a follow-up level at least 3 months following surgery. Of the 77 patients included, 72 underwent elective repair, median age was 75 (39-91) years, and 65 % were female. Cameron erosions were identified preoperatively in 32 %. Mean preoperative hemoglobin was 9.6 (4.4-13.6) g/dl and postoperative hemoglobin was 13.2 (10.7-17) g/dl at 3-12 months and 13.6 (9.7-17.2) g/dl at more than 1 year. Ninety percent of patients had a rise in postoperative hemoglobin level by at least 1 g/dL. Anemia resolved in 55 (71 %) patients, more often in women and younger patients (< 70 years). Twenty-nine of 40 (73 %) patients on iron therapy discontinued this postoperatively. A significant number of patients who present with giant PEH will present with iron-deficiency anemia. Elective repair will result in resolution of the anemia in more than 70 % of patients. PEH is underappreciated as a source of iron-deficiency anemia, and appropriate patients should be considered for elective repair.
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