Hiatal Hernia Complicated by Benign Esophageal Stricture in a Developmentally Delayed Male

Benign esophageal strictures can be defined as a lumennarrowing lesion of the esophagus with no associated malignancy. Severe reflux is the most common asosiated etiology of stricture formation in adults. Hiatal hernias can cause severe reflux and have been identified as a cause of esophageal strictures in adults [1]. Sliding hiatal hernias are characterized by the weakening of diaphragmatic crura and a resulting projection of the stomach, through the diaphram. Hiatal hernias in children are almost exclusively congenital in which case repair is warranted early in life for symptomatic cases to ensure adequate nutritional tolerance and growth. Most sliding hiatal hernias in adults remain largely asymptomatic. Acquired hiatal hernias are only symptomatic less than 10% of the time [2]. Here, we present a case of a developmentally delayed adolescent male who presents with weight loss and recurrent vomiting, found to have a hiatal hernia and esophageal stricture. This case underscores the importance of considering and pursuing strictures and underlying reflux pathologies in cases of recurrent persistent oral intolerance and weight loss, especially in developmentally delayed children who are unable to give an accurate or reliable history of symptoms. Case Report