Atypical Appearance of Cameron Lesion Casting Diagnostic Doubt

Abstract

The term Cameron lesions denotes the presence of linear erosions or ulcer on the crests of gastric folds in the distal neck of hiatal hernia. They are well described distinct clinical entity more often asymptomatic and associated with chronic anemia, while less often represent the source of profuse upper gastrointestinal bleeding. Not infrequently Cameron lesions are overlooked at endoscopy due to technical and anatomical difficulties. They can also be the subject of diagnostic doubt when chronicity of mechanical and ischemic trauma leads to deep callous and fibrotic ulcer that resembles neoplastic lesion. We describe a patient with overt gastrointestinal hemorrhage in whom Cameron lesion was misperceived as neoplastic lesion resulting in extensive and prolonged diagnostic evaluation. Endoscopists and gastroenterologist should be well aware of this condition and have it in consideration in all patients with acute gastrointestinal bleeding, particularly in those with hiatal hernia with or without chronic anemia