Gupta Prashant, Suryadevara Madhu, Das Avash, Falterman James
Department of Medical Education, Preventive Compliance Solutions, Broussard, USA.
Department of Internal Medicine, Louisiana State University Health Sciences Center - University Hospital and Clinics, Lafayette, USA.
Am J Case Rep. 2015 Oct 15;16:733-6. doi: 10.12659/ajcr.894145.
Cameron lesions are linear gastric erosions on the mucosal folds at the diaphragmatic impressions found in patients with large hiatal hernias. While usually asymptomatic, hiatal hernias can result in serious sequelae, as this case report will clearly illustrate. Cameron lesions are clinically significant because of their ability to cause significant acute, chronic, or obscure gastrointestinal bleeding, often requiring blood transfusions.
In this report, we present the case of a 51-year-old white woman who originally presented to the Emergency Department with complaints of a runny nose, dry cough, generalized weakness, and muscle cramping ascribed to a viral infection. However, closer examination revealed substantial pallor with pale conjunctiva prompting further workup that revealed substantial anaemia. Upon further inquiry of her past medical history, she revealed the need for previous blood transfusions, and meticulous review of her medical record indicated a previous diagnosis of hiatal hernia with the presence of Cameron lesions based on esophagogastroduodenoscopy 2 years prior.
This case emphasizes the need for a high index of suspicion for Cameron lesions as a causative agent of substantial blood loss in patients with hiatal hernias after other common causes of gastrointestinal bleeding have been ruled out.
卡梅伦病变是指在患有巨大食管裂孔疝的患者中,于膈肌压迹处的黏膜皱襞上出现的线性胃糜烂。虽然食管裂孔疝通常无症状,但正如本病例报告将清楚表明的那样,它可导致严重的后遗症。卡梅伦病变具有临床意义,因为它们能够引起严重的急性、慢性或隐匿性胃肠道出血,常常需要输血治疗。
在本报告中,我们介绍了一名51岁白人女性的病例。她最初因流涕、干咳、全身无力和肌肉痉挛等症状就诊于急诊科,这些症状被归因于病毒感染。然而,进一步检查发现她面色苍白,结膜苍白,这促使进一步检查,结果显示有严重贫血。在进一步询问她的既往病史时,她透露曾有输血史,仔细查阅她的病历发现,两年前基于食管胃十二指肠镜检查曾诊断她患有食管裂孔疝并伴有卡梅伦病变。
本病例强调,在排除其他常见的胃肠道出血原因后,对于患有食管裂孔疝的患者,高度怀疑卡梅伦病变是导致大量失血的病因是很有必要的。