Case Report
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 21, 2012; 18(35): 4959-4961
Published online Sep 21, 2012. doi: 10.3748/wjg.v18.i35.4959
Cameron ulcers: An atypical source for a massive upper gastrointestinal bleed
Samir Kapadia, Sophia Jagroop, Atul Kumar
Samir Kapadia, Department of Medicine, Stony Book University School of Medicine, Stony Brook, NY 11794, United States
Sophia Jagroop, Atul Kumar, Gastroenterology and Hepatology, Northport VA Medical Center, Northport, NY 11768, United States
Author contributions: Kapadia S, Jagroop S, and Kumar A contributed equally to this work; Jagroop S and Kumar A performed the procedures; Kapadia S and Jagroop S wrote the paper.
Correspondence to: Atul Kumar, MD, Assistant Professor of Medicine, Gastroenterology and Hepatology, Northport VA Medical Center, 79 Middleville Rd., Northport, NY 11768, United States. atul.kumar2@va.gov
Telephone: +1-631-88978511 Fax: +1-631-4866113
Received: March 22, 2012
Revised: July 4, 2012
Accepted: August 4, 2012
Published online: September 21, 2012
Abstract

Cameron lesions represent linear gastric erosions and ulcers on the crests of mucosal folds in the distal neck of a hiatal hernia (HH). Such lesions may be found in upto 50% of endoscopies performed for another indication. Though typically asymptomatic, these may rarely present as acute, severe upper gastrointestinal bleed (GIB). The aim is to report a case of a non-anemic 87-year-old female with history of HH and atrial fibrillation who presented with hematemesis and melena resulting in hypovolemic shock. Repeat esophagogastroduodenoscopy was required to identify multiple Cameron ulcers as the source. Endoscopy in a patient with HH should involve meticulous visualization of hernia neck and surrounding mucosa. Cameron ulcers should be considered in all patients with severe, acute GIB and especially in those with known HH with or without chronic anemia.

Keywords: Cameron lesion; Upper gastrointestinal bleeding; Shock; Hiatal hernia