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

## TL;DR

A rare case of a child with iron deficiency anemia linked to a hiatal hernia showed improvement after surgical repair.

## Contribution

Highlights hiatal hernia as a rare but significant cause of iron-refractory anemia in children.

## Key findings

- Surgical repair of hiatal hernia restored response to iron therapy in a child with iron-refractory anemia.
- Normalization of hemoglobin levels was observed after hernia repair.
- Hiatal hernia can cause chronic gastrointestinal bleeding leading to anemia.

## Abstract

Iron deficiency anemia remains a significant health problem in children. Gastrointestinal blood loss is a recognized cause of iron deficiency in this population. Although rare, hiatal hernia has been reported as a source of chronic gastrointestinal bleeding, potentially leading to iron refractory iron deficiency anemia (IDA). A 4‐year‐old male child with iron refractory IDA had previously received multiple blood transfusions for recurrent anemia. During evaluation for complicated pneumonia, a chest computed tomography scan incidentally revealed a hiatal hernia. Following surgical repair of the hernia, iron refractory IDA responded to iron supplementation and follow‐up complete blood counts at 2 and 6 months demonstrated normalization of hemoglobin levels. Clinicians should be aware that hiatal hernia might represent a rare but significant cause of anemia in children with iron refractory IDA.

Hiatal hernia, though rare, can cause chronic gastrointestinal bleeding and iron‐refractory iron deficiency anemia.Persistent or unexplained anemia should prompt evaluation for underlying structural causes.Early recognition and surgical repair can restore response to iron therapy, normalize hemoglobin, reduce transfusions and improve long‐term outcomes.

Hiatal hernia, though rare, can cause chronic gastrointestinal bleeding and iron‐refractory iron deficiency anemia.

Persistent or unexplained anemia should prompt evaluation for underlying structural causes.

Early recognition and surgical repair can restore response to iron therapy, normalize hemoglobin, reduce transfusions and improve long‐term outcomes.