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Cameron ulcers: an atypical source for a massive upper gastrointestinal bleed.
Samir Kapadia1, Sophia Jagroop, Atul Kumar
1Department of Medicine, Stony Book University School of Medicine, Stony Brook, NY 11794, United States.
World Journal of Gastroenterology
|September 25, 2012
Summary
Cameron ulcers, linear erosions in hiatal hernias, can cause severe upper gastrointestinal bleeding. Early identification during endoscopy is crucial for prompt diagnosis and management of these rare but serious bleeding events.
Area of Science:
- Gastroenterology
- Endoscopy
- Gastrointestinal Bleeding
Background:
- Cameron lesions are linear erosions/ulcers found on mucosal folds within hiatal hernias.
- While often asymptomatic, they can rarely cause significant upper gastrointestinal bleeding (GIB).
- Hiatal hernias (HH) are common, and associated lesions may be underrecognized.
Observation:
- A case report details an 87-year-old female with a history of HH presenting with severe hematemesis and melena.
- The patient experienced hypovolemic shock, necessitating repeat esophagogastroduodenoscopy.
- Multiple Cameron ulcers were identified as the source of bleeding.
Findings:
- Cameron ulcers can present as a cause of acute, severe GIB, even in non-anemic patients.
- Meticulous endoscopic visualization of the hernia neck and surrounding mucosa is essential in patients with HH.
- The diagnosis required repeat endoscopy, highlighting potential diagnostic challenges.
Implications:
- Cameron ulcers should be considered in the differential diagnosis of severe acute GIB, particularly in patients with known HH.
- Awareness of these lesions can improve diagnostic yield and patient outcomes.
- Endoscopic surveillance protocols for HH may need to emphasize careful examination for Cameron lesions.
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