Cameron Ulcers: Rare Case of Overt Upper Gastrointestinal Bleed in a Patient with Alcohol Use Disorder

Abstract

Cameron lesion is an uncommon cause of overt upper gastrointestinal bleed (GI bleed). Though hiatal hernia is a well-known entity, Cameron lesions that may occur in them are usually missed during upper endoscopy. Patient with Cameron lesions usually presents as chronic iron deficiency anemia, rarely as acute GI bleed. Multiple other risk factors such as non-steroidal anti-inflammatory drug use, alcohol consumption, gastro-esophageal reflux disease (GERD) may be present concomitantly which makes initial differential diagnosis of Cameron lesions more difficult as seen in our case.

Paraesophageal hernia and iron deficiency anemia: Mechanisms, diagnostics and therapy

“…In the hiatal hernia itself, the so-called Cameron lesions are repeatedly referred to as macroscopic correlates of bleeding activity[ 16 ] (Figure 1 ). These lesions are often overlooked or misinterpreted on gastroscopy, hindering a clear estimate of their prevalence[ 17 , 18 ]. According to different studies, they are present in 5%-50%[ 7 , 19 , 20 ] of all hernias, occurring mainly in larger hernias (> 5 cm)[ 21 ].…”

Hiatal Hernia With Gastric Perforation

“…Hiatal hernias can additionally present with upper gastrointestinal bleeding secondary to gastric ulcerations at the level of herniation, known as Cameron ulcers. These ulcers are attributed to impingement of the stomach at the level of herniation and results in mucosal ischemia [ 2 , 3 ]. Asymptomatic hiatal and paraesophageal hernias become symptomatic and necessitate repair at a rate of 1% per year [ 4 , 5 ].…”