Úlcera de cameron como causa incomum de anemia por deficiência de ferro / Cameron ulcer as uncommon cause of iron-deficiency anemia

Úlceras de cameron são lesões lineares crônicas dispostas sobre as pregas da mucosa, ao nível da impressão diafragmática, em pacientes portadores de hérnia hiatal. Sua relevância clínica deve-se ao potencial risco de complicação gastrointestinal, como sangramento agudo ou crônico e anemia ferropriva. Geralmente, o diagnóstico é incidental por endoscopia digestiva alta. Inibidores da bomba de prótons são essenciais para a condução dos casos e a administração de ferro quando a anemiaestiver associada. Entretanto, situações refratárias se beneficiam do tratamento cirúrgico. Apresentamos um caso desta entidade em uma paciente de 50 anos na pós-menopausa que evoluiu com anemia por deficiência de ferro e exames endoscópicos iniciais normais.

Cameron ulcers are chronic linear lesions willing on the mucosal folds, the level of diaphragmatic impression, in patients with hiatal hernia. Its clinical relevance is due to the potential risk of gastrointestinal complications, such as acute or chronic bleeding and anemia. Usually, the diagnosis is incidental by upper gastrointestinal endoscopy. Proton pump inhibitors are essential for the conduct of cases and the administration of iron when the anemia is associated. Already, the benefi t of surgery is in refractory cases. We present a case of this entity of a 50-year-old patient in postmenopausal who developed anemia due to iron deficiency and normalinitial endoscopy.

A Case of Cameron Ulcer Associated with Massive Gastrointestinal Bleeding Treated by Angiographic Embolization

Gastric erosions or ulcers located at or near the level of the neck of a large diaphragmatic hernias are referred to as Cameron ulcers. Cameron ulcers are almost always incidental findings. In some patient, Cameron ulcers cause the dyspepsia, gastroesophageal reflux disease and iron deficiency anemia due to chronic gastrointestinal bleeding or even acute bleeding. We report the case of an acute upper gastrointestinal bleeding due to a Cameron ulcer in a patient with a history of aspirin and NSIADs use, which was successfully treated with angiographic coil embolization.

A Case of Cameron Ulcers associated with Iron Deficiency Anemia / 대한소화기내시경학회지

Patients suffering with sliding hiatal hernia may develop Cameron erosions or ulcers. Mechanical trauma, ischemia, and peptic injury have been proposed as the etiology of these lesions. These lesions can be associated with iron deficiency anemia and GI bleeding. An 83-year-old woman was admitted with iron deficiency anemia and intermittent melena. Her past history consisted of pneumonia and pulmonary tuberculosis. She had no current medication history. The laboratory findings were Hb 6.8 g/dL, MCV 75 fL and MCH 23.6 pg. Upon esophagogastroduodenoscopy (EGD), a huge diaphragmatic hernia was noted and multiple ulcers were located at the neck of the hernia. Esophagogram showed a huge diaphragmatic hernia. The bleeding ceased and the anemia was resolved after proton pump inhibitor treatment.