Cameron lesions are erosions and/or ulcers which develop on gastric folds prolapsing into a hiatal hernia. Although infrequent, these lesions have a clinically relevant impact by causing either acute haemorrhage or chronic iron-deficiency anaemia. In detail, Cameron lesions were detected in 0.2% of patients with manifest upper gastrointestinal (GI) bleeding and in 1.9%-9.2% of patients with chronic anaemia. The pathogenesis still remains unclear, but an ischaemic damage of gastric mucosa during diaphragmatic contraction seems to be the most acknowledged hypothesis. It is not always easy to detect these lesions, as demonstrated by the observation that several patients underwent more endoscopic examinations, blood transfusions and admissions before diagnosis was achieved. The endoscopic features range from one or more linear erosions on the gastric folds to large ulcers resembling neoplasia. At endoscopy, a therapeutic approach is applicable only when active bleeding is detected. A high-dose, long-term therapy with proton-pump inhibitor therapy, together with iron supplementation, is generally needed, but the surgical repair of hiatal hernia is the only definitive approach.
Cameron lesions: Clinical impact, endoscopic diagnosis and therapy / De Francesco, V.; Manta, R.; Ridola, L.; Zullo, A.. - In: GIORNALE ITALIANO DI ENDOSCOPIA DIGESTIVA. - ISSN 0394-0225. - 2019:3(2019), pp. 24-29.
Cameron lesions: Clinical impact, endoscopic diagnosis and therapy
Ridola L.;
2019
Abstract
Cameron lesions are erosions and/or ulcers which develop on gastric folds prolapsing into a hiatal hernia. Although infrequent, these lesions have a clinically relevant impact by causing either acute haemorrhage or chronic iron-deficiency anaemia. In detail, Cameron lesions were detected in 0.2% of patients with manifest upper gastrointestinal (GI) bleeding and in 1.9%-9.2% of patients with chronic anaemia. The pathogenesis still remains unclear, but an ischaemic damage of gastric mucosa during diaphragmatic contraction seems to be the most acknowledged hypothesis. It is not always easy to detect these lesions, as demonstrated by the observation that several patients underwent more endoscopic examinations, blood transfusions and admissions before diagnosis was achieved. The endoscopic features range from one or more linear erosions on the gastric folds to large ulcers resembling neoplasia. At endoscopy, a therapeutic approach is applicable only when active bleeding is detected. A high-dose, long-term therapy with proton-pump inhibitor therapy, together with iron supplementation, is generally needed, but the surgical repair of hiatal hernia is the only definitive approach.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.