Background and study aims
Cameron lesions, as defined by erosions and ulcerations at the diaphragmatic hiatus, are found in the setting of gastrointestinal (GI) bleeding in patients with a hiatus hernia (HH). The study aim was to determine the epidemiology and clinical manifestations of Cameron lesions.
Patients and methods
This is a retrospective cohort study evaluating consecutive patients undergoing upper endoscopy over a two year period. Endoscopy reports were systematically reviewed to determine presence or absence of Cameron lesions and hiatus hernia. Inpatient and outpatient records were reviewed to determine prevalence, risk factors, and outcome of medical treatment of Cameron lesions.
Results
Of 8260 upper endoscopic examinations, 1306 (20.2%) reported a HH. When categorized by size, 65.6% of HH were small (<3 cm), 23.0% moderate (3-4.9 cm) and 11.4% were large (≥5 cm). Of these, 43 patients (mean age 65.2 years, 49% female) had Cameron lesions, with a prevalence of 3.3% in the presence of HH. Prevalence was highest with large HH (12.8%). On univariate analysis, large HH, frequent NSAID use, GI bleeding (both occult and overt) and nadir hemoglobin level were significantly greater with Cameron lesions compared to HH without Cameron lesions (p≤0.03). Large HH size and NSAID use were identified as independent risk factors for Cameron lesions on multivariate logistic regression analysis.
Conclusions
Cameron lesions are more prevalent in the setting of large HH and NSAID use, can be associated with GI bleeding, and can respond to medical management.
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