Rajaram-Gilkes Mathangi, Cardona Juan J, Gilkes Aishwarya J
Department of Medical Education, Geisinger Commonwealth School of Medicine, Scranton, USA.
Department of Neurosurgery, Tulane University School of Medicine, New Orleans, USA.
Cureus. 2023 Dec 17;15(12):e50678. doi: 10.7759/cureus.50678. eCollection 2023 Dec.
This case presentation involves an elderly patient presenting with signs of severe anemia. Investigations lead to the detection of Cameron lesions within a large paraesophageal hiatus hernia (HH). These lesions have been described in the literature as being an incidental finding within the herniated stomach during endoscopy in patients with large HH who presented with microcytic hypochromic anemia. Progressive information regarding the relationship of this occurrence in patients with this specific type of anemia associated with HH has heightened physician awareness to rule out these lesions as a primary cause of chronic bleeding. There has been sporadic publication in literature stating Cameron lesions to be an unusual cause of chronic blood loss resulting in microcytic hypochromic anemia. Perhaps due to the lack of adequate emphasis on this frequent finding in elderly with HH in literature, textbooks are yet to include this condition as a differential diagnosis as one of the causes of upper GI bleeding (UGIB). This case study makes us ponder if this etiology is not rare after all and emphasizes the importance of considering Cameron lesions to be one of the established causes of chronic blood loss of upper GI origin in elderly with a large HH. Screening methods such as chest X-rays (CXR) could be used for early detection of the condition, and an esophagogastroduodenoscopy (EGD) for confirmation before requiring additional invasive investigations.
该病例报告涉及一名出现严重贫血症状的老年患者。检查发现一个巨大的食管裂孔疝（HH）内有卡梅伦病变。这些病变在文献中被描述为在患有大HH且伴有小细胞低色素性贫血的患者进行内镜检查时，在疝入的胃内偶然发现的。关于这种情况在患有与HH相关的这种特定类型贫血的患者中的发生关系的进一步信息，提高了医生对排除这些病变作为慢性出血主要原因的认识。文献中曾有零星报道称卡梅伦病变是导致小细胞低色素性贫血的慢性失血的不寻常原因。也许由于文献中对HH老年患者中这种常见发现缺乏足够的重视，教科书尚未将这种情况作为上消化道出血（UGIB）原因之一的鉴别诊断纳入其中。本病例研究促使我们思考这种病因是否毕竟并不罕见，并强调考虑卡梅伦病变是患有大HH的老年人上消化道起源慢性失血的既定原因之一的重要性。诸如胸部X光（CXR）等筛查方法可用于该疾病的早期检测，而食管胃十二指肠镜检查（EGD）则用于在需要额外的侵入性检查之前进行确诊。
