A 67-year-old woman was admitted to the Digestive Appliance Service for the study of microcytic anemia and heartburn.
The patient had a hemoglobin level of 6.4 g/dl, with MCV 61 μm3 and fertigation profile.
A gastroscopy revealed a large hiatal hernia with a mixed component and a delustrated mucosa in fundus, antrum and body.
The barium radiological study showed a horizontalization of the stomach in the mediastinum, with the gastric body and the largest at the tracheal level, and the gastric fundus junction (inferior to the gastric fundus).
In addition, she had a marked delay in the removal of contrast by the pylorus.
The left hemidiaphragm was not identified.
It was then decided to request a chest computed tomography that confirmed the findings.
Surgical repair of the large mixed hernia was proposed in view of the risk of possible volvulus, but the patient refused surgery.
She is currently asymptomatic.
