![]() The treatment options include medical management, surgery, and endoscopic intervention. Given the short transit time and the cost involved, it is unlikely to be a diagnostic modality of choice. The usefulness of capsule endoscopy has not been fully documented. They have also been shown to be useful in situations where there are no well-defined lesions. Newer diagnostic studies like magnification chromoendoscopy may be useful to demonstrate the mucosal defects. Cameron lesions usually present as linear erosions of the gastric mucosa, frequently with erythematous borders. Endoscopic findings include mucosal erythema, edema, and ecchymotic bleeding, along with the Cameron lesions in the gastric mucosal folds. The endoscopic evaluation involves careful antegrade and retrograde visualization of the region and the hernia sac and adjacent mucosa. They are often missed on the initial endoscopy and are usually discovered on subsequent endoscopies. Įndoscopy is the gold standard for diagnosis, although it is not uncommon to overlook these lesions due to their unique location. The hernias are usually seen on radiographic films but not the Cameron lesions. A barium swallow is also a non-invasive modality to diagnose hiatal hernia. The chest x-ray may help visualize the hiatal hernia, showing a large posterior mediastinum structure. Iron studies reveal low iron and ferritin levels with high total iron-binding capacity. ![]() The laboratory tests show iron deficiency with low hemoglobin levels and microcytic hypochromic anemia. Ĭameron lesions pose a diagnostic challenge to physicians. Studies have shown that inadequate fiber intake and high sitting position during defecation could be possible risk factors for developing Cameron lesions. There has been no correlation with any environmental factors or genetics. There are few cases reported from Africa, but this could be attributed to underreporting. Most of the cases have been reported from developed countries, including North America and Western Europe. The prevalence is higher in females as compared to males. It is rare in the pediatric subgroup of patients, with the youngest patient 3 years of age. Since the frequency of hiatal hernia increases with age, most cases are reported in the elderly population. The size of the hiatal hernia correlates directly with the prevalence of these lesions. Ĭameron lesions may heal spontaneously within a couple of days, contributing to the underreporting of these lesions. ![]() Cameron lesions are seen in 5% of patients with known hiatal hernia discovered on upper endoscopic studies. The combination of NSAIDs and SSRIs increased risk was 1.6.The prevalence rates of hiatal hernia range from 0.8 to 2.9 in all patients undergoing upper gastrointestinal endoscopy. Concomitant use of nonsteroidal anti-inflammatory drugs and low-dose aspirin with aldosterone antagonists such as Aldactone produce an increased risk for upper GI bleeding of up to 11 times. Concomitant use of NSAIDs, COX-2 inhibitors, or low-dose aspirin and corticosteroid therapies increased the risk for upper GI bleeding (up to 12.8 times). Recent data show an increased risk of GI bleeding with certain combinations of drugs. ![]() The serotonin reuptake inhibitors (SSRIs) have been implicated as a possible cause of GI bleeding. Definite risk factors for bleeding in patients taking aspirin and clopidogrel are a history of peptic ulcers and prior GI bleeding, and likely risk factors are male gender, age more than 70, and Helicobacter pylori infection. Compared with aspirin alone, the combination of aspirin and clopidogrel causes a two- to threefold increase in the number of patients with major GI bleeding. Among patients on long-term, low-dose aspirin, the risk of overt GI bleeding is increased twofold compared to placebo with an annual incidence of major GI bleeding of 0.13%. ![]()
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