Hiatus Hernia with Esophagitis and Acute Hemorrhage

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Abstract
Severe hemorrhage occurred in 8 of 30 cases in which peptic esophagitis was accompanied by hiatal hernia. All cases were diagnosed by esophagoscopy. X-ray studies were not adequate and were some times misleading. The presence of the hiatal hernia was thought to permit the regurgitation of the acid-pepsin mixture from the stomach and thus to allow the erosive esophagitis with resultant hemorrhage to ensue. Seven of 8 cases were surgically managed by repair of the hiatal hernia, and there has been no recurrence of the hemorrhage in an 18-month followup period. This entity is important as a cause of serious upper gastrointestinal hemorrhage. Its medical and surgical treatment is discussed.

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