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

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.