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June 1960

Anemia as a Presenting Symptom of Esophageal Hiatal Hernia of the Diaphragm

Author Affiliations

New York

From the Departments of Medicine and Surgery, St. Vincent's Hospital of the City of New York.; Associate Attending Physician (Dr. Felder) and Senior Medical Resident (Dr. Masley), St. Vincent's Hospital; Associate Visiting Thoracic Surgeon, St. Vincent's Hospital, and Assistant Clinical Professor Surgery, New York University-Bellevue Medical Center (Dr. Wolff).

AMA Arch Intern Med. 1960;105(6):873-883. doi:10.1001/archinte.1960.00270180051007

In recent years esophageal hiatal hernia has been established as a symptom-producing entity worthy of differential diagnosis in coronary artery disease, cholecystitis, peptic ulcer, carcinoma, and anemia. Despite the wealth of literature on hiatal hernia, its association with anemia, although well recognized, is only sporadically discussed. It is with this aspect of esophageal hiatal hernia that this report deals.

Classification  Neglecting the harassing aspects of embryology, anatomy, and physiology, a most useful, simple, and descriptive classification of esophageal hiatal hernia is that suggested by Mobley and Christensen.1

  • Esophageal hiatal hernia without shortening of the esophagus

    • With upward displacement of the esophagogastric junction (sliding type)

    • Without displacement of the esophagogastric junction (paraesophageal type)

  • Esophageal hiatal hernia with shortening of the esophagus

    • Acquired

    • Congenital

The most common type encountered is the hernia without shortening of the esophagus, but with upward displacement of the esophagogastric junction (sliding type). A more complete classification is that of Harrington2

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