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August 1951

MASSIVE HEMATEMESIS FROM HIATUS HERNIAReport of Four Cases with Discussion of Etiology

AMA Arch Surg. 1951;63(2):143-146. doi:10.1001/archsurg.1951.01250040147002

GASTROINTESTINAL bleeding may on occasion be found in patients with no demonstrable lesion other than hiatus hernia. It is unreasonable to believe that a hernia in the gastrointestinal tract will give rise to bleeding per se. Frank ulceration, or at least mucosal erosion, must be present in the herniated viscus to account for the complication. Other writers on the subject agree with this opinion.1

Hiatus hernia has been estimated to be present in from 0.06 to 2.9 per cent of all patients subjected to roentgen examination of the gastrointestinal tract.2 The apparent increasing incidence of hiatus hernia in recent surveys as compared with those of earlier years is undoubtedly due to its more frequent recognition.3 Many persons with hiatus hernia live a normal span of years without any signs or symptoms referable to this anatomical abnormality. Why certain patients with hiatus hernia experience blood loss remains a

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