Hiatal Hernia as a Mysterious Diagnosis; a Case Report

Introduction Proximal displacement of stomach and gastro-esophageal junction into the thoracic cavity results in a condition known as Hiatal Hernia (HH). Sometimes this entity is overlooked in practice and patients are managed as non-surgical diagnoses such as gastroesophageal reflux disease or asthma. Case Report A 6 month-old female infant has presented with bloody emesis for four months. She was evaluated and diagnosed with gastritis and treated with proton pump inhibitors accordingly. She later developed respiratory symptoms and a chest x-ray was ordered. It showed a retro cardiac shadow by which the correct diagnosis was reached Discussion In the primary work up of patients with gastrointestinal or respiratory symptoms anatomical abnormalities should be considered. HH is an example of these abnormalities that is frequently missed by primary care physicians especially in the pediatric population.