Case Report on Upper Gastrointestinal Bleeding with Esophagitis, hiatus hernia and severe Anemia

Introduction: Hiatal hernia develops when the belly protrudes past the esophageal gap into the thoracic cavity. In this cases upper gastrointestinal endoscopy's prevalence rate is observed to be 0.8-5.2 percent. Case presentation: A 65-year-old- male admitted in Tertiary care hospital Wardha,at medicine HDU after RAT negative test.With the complaints of breathlessness, which was sudden in onset and present on excretion since 4 days, complaints of malena which was sudden in onset and since 4 days. No history of hematemesis, abdominal pain, nausea, vomiting. No history of cold, cough, fever, syncope, loss of consciousness. No history of trauma. Previous treatment, no prior hospitalization. There was no associated illness were present like Diabetes mellitus, tuberculosis, and thyroid disorder. No any significant past history. Physical examination and systemic examination was done. In respiratory system: bilateral clear, cardiovascular: heart sound was normal, central nervous system: conscious and oriented, abdominal examination: soft and nontender. No any abnormality detected in musculoskeletal system. Conservative management: All the routine investigation done. Hemoglobin 5.5gm% was on lower side.ECG and X-ray was done which was normal. Patient was transfused with 2 units of packed red cells (PRC) in view of low HB. Patient was started on PAN infusion and other supportive medications. Ultrasonography was done at bedside which was suggestive of bilateral cortical echotexture of kidney with grade I prostatomegaly. Gastroenterologist opinion was taken and patient was advice for endoscopy. Which was suggestive of large hiatus hernia-hill's grade IV. Patient was advised for repeat CBC, if in lower side then repeat endoscopy, and surgery opinion was taken SOS in emergency (Strangulation, bleeding, obstruction and volvulus). Surgery opinion was taken and patient was advised for conservative management. Conclusion: due to conservative management and quality nursing care patient condition was stable and had no active complaints at present hence patient is being discharged.