Symptomatic Anemia Due to Cameron Lesions: A Case Report

Abstract

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.

Keywords: cameron lesions; gastrointestinal bleeding; hiatal hernia; iron deficiency anemia; shortness of breath (sob).

Figure 1. Chest X-ray, posterior-anterior view (A) and lateral view (B)

The radiologist’s impression was a large hiatal hernia, which may be slightly larger than prior. No consolidation was seen. The arrows point to the large hiatal hernia.

Figure 2. Cameron lesions in the stomach

These two images (A and B) were obtained during endoscopy. The blue arrows in both images point to the Cameron lesions.