The physiology of a Hiatal Hernia When Diving?

[Duke Dive Medicine]

Sounds like you have a good plan. At the risk of sounding repetitive, I wouldn't tunnel in on the hiatal hernia to the exclusion of other potential sources of bleeding. Not sure if you have risk factors, but an aortic aneurism or AVM outside the GI tract could present the same way. Though there aren't any case reports that I know of, the redistribution of blood to the torso that occurs with immersion could theoretically result in a transient increase in intravascular pressure that could lead to bleeding in weakened areas of a vessel. Just something to consider.

Best regards,
DDM

 

[Canyondreamer]

Please do . . . This is a very odd case. I am assuming, although you didn't specifically mention it, that you did have a colonoscopy done, since they are contemplating a capsule endoscopy.

Trust me, when I said "million-dollar-work-up" it was "almost" correct!!: Upper lower endoscopy that were totally clean except for the large HH (had kept up on my routine Q5Y colonoscopies), Barium swallow w/SB follow-through prestine (except for the large HH) and a first pill cam endoscopy showing no bleeding source or other abnormality in the SB.

 

[cutlass]

Indeed not a straightforward case.

Just a thought: So transferrin was "low-low". Was ferritin or hepcidin also measured?