Girgis Karim, Gaetani Samantha, O'Gurek David T, Greenberg Marna R
Department of Emergency and Hospital Medicine, Lehigh Valley Health Network, Allentown, USA.
Morsani College of Medicine, University of South Florida, Tampa, USA.
Cureus. 2024 Nov 6;16(11):e73131. doi: 10.7759/cureus.73131. eCollection 2024 Nov.
Cameron lesions are a unique and relatively rare cause of upper gastrointestinal bleeding that appears in the mucosa of the gastric body in the presence of a large hiatal hernia. These lesions can be a source of occult bleeding and subsequent chronic iron deficiency anemia (IDA) but may often be missed on initial endoscopy, requiring repeat studies to diagnose. Prompt treatment for Cameron lesions is necessary to avoid the high mortality rate associated with them. We describe the case of a 36-year-old male patient who presented to the emergency department (ED) with shortness of breath (SOB) and chronic IDA of an unknown cause in the presence of a large hiatal hernia. The endoscopy showed multiple linear erosions in the stomach consistent with Cameron lesions. The patient was discharged but returned to the ED two more times before ultimately having his hiatal hernia surgically repaired. Though rare, Cameron lesions may be considered in the differential for patients presenting with recurrent SOB or with chest or abdominal pain, combined with refractory anemia of an unknown cause.
卡梅伦病变是上消化道出血的一种独特且相对罕见的病因，出现在存在巨大食管裂孔疝时的胃体黏膜中。这些病变可能是隐匿性出血及随后慢性缺铁性贫血（IDA）的一个来源，但在初次内镜检查时常常会被漏诊，需要重复检查才能确诊。对卡梅伦病变进行及时治疗对于避免与其相关的高死亡率是必要的。我们描述了一名36岁男性患者的病例，该患者因呼吸急促（SOB）以及在存在巨大食管裂孔疝的情况下病因不明的慢性IDA而就诊于急诊科（ED）。内镜检查显示胃内有多处线性糜烂，符合卡梅伦病变。患者出院，但在最终接受食管裂孔疝手术修复之前又两次返回急诊科。尽管罕见，但对于出现反复呼吸急促或伴有胸部或腹部疼痛且合并病因不明的难治性贫血的患者，鉴别诊断时可能要考虑卡梅伦病变。
