Department of General, Vascular and Visceral Surgery, Steyr Regional Hopsital, Steyr, Austria.
Institute of Pathology, Steyr Regional Hospital, Steyr, Austria.
Am J Case Rep. 2021 Jan 21;22:e928021. doi: 10.12659/AJCR.928021.
BACKGROUND Cameron lesions are linear erosions and ulcers on the crests of gastric mucosal folds in the neck of a hiatal hernia and can be difficult to diagnose and treat. This report is of a case of chronic iron deficiency in a 61-year-old woman with a late diagnosis of a Cameron lesion, who did not respond to a single treatment with the proton pump inhibitor (PPI) pantoprazole, but was then treated with oral poloxamer 407 with hyaluronic acid and chondroitin sulfate in addition to PPI. CASE REPORT We report the case of a 61-year-old women with recurrent iron-deficiency anemia, first diagnosed 40 years prior to her presentation at our Endoscopy Unit, and an ongoing melena. We discovered an intrahiatal gastric mucosal defect, which we at first treated with proton pump inhibitors and sucralfate. After a follow-up gastroscopy revealed the persistence of the lesion, we decided to incorporate into the treatment a gel-like substance containing, among others, hyaluronic acid and chondroitin sulfate, and observed that the lesion resolved completely. CONCLUSIONS This report highlights that Cameron lesions should be considered in patients with hiatal hernia who have iron-deficiency anemia and can be diagnosed on upper endoscopy. Further clinical studies are required to determine the role of combined poloxamer 407 with hyaluronic acid and chondroitin sulfate in the management of Cameron lesions.
卡梅隆病变是食管裂孔疝颈部胃黏膜皱襞嵴上的线性糜烂和溃疡，可能难以诊断和治疗。本报告介绍了一例 61 岁女性慢性缺铁病例，其卡梅隆病变诊断较晚，质子泵抑制剂（PPI）泮托拉唑单一治疗无效，但随后在 PPI 基础上加用含有透明质酸和硫酸软骨素的口服泊洛沙姆 407 治疗后，病变完全缓解。
我们报告了一例 61 岁女性反复缺铁性贫血病例，其首次诊断为 40 年前在我们的内镜科就诊时，并持续出现黑便。我们发现食管裂孔内胃黏膜缺损，最初用质子泵抑制剂和硫糖铝治疗。随访胃镜显示病变持续存在后，我们决定在治疗中加入一种含有透明质酸和硫酸软骨素等物质的凝胶状物质，并观察到病变完全缓解。
本报告强调，对于患有缺铁性贫血的食管裂孔疝患者，应考虑卡梅隆病变，可通过上消化道内镜诊断。需要进一步的临床研究来确定泊洛沙姆 407 联合透明质酸和硫酸软骨素在卡梅隆病变治疗中的作用。
