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15 October 2015 : Case report  USA

Cameron Ulcer Causing Severe Anemia in a Patient with Diaphragmatic Hernia

Challenging differential diagnosis, Rare coexistence of disease or pathology

Prashant GuptaABDE, Madhu SuryadevaraCD, Avash DasDEF, James FaltermanCD

DOI: 10.12659/AJCR.894145

Am J Case Rep 2015; 16:733-736

Abstract

BACKGROUND: 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.

CASE REPORT: 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.

CONCLUSIONS: 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.

Keywords: Diagnosis, Differential, Anemia - etiology, Endoscopy, Gastrointestinal, Hernia, Diaphragmatic - diagnosis, Severity of Illness Index, Stomach Ulcer - diagnosis

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923