Cameron lesions

A Cameron lesion is a linear erosion or ulceration of the mucosal folds lining the stomach where it is constricted by the thoracic diaphragm in persons with large hiatal hernias.

Treatment of anemia with Cameron lesions includes iron supplements and acid suppression by a proton-pump inhibitor (PPI).

Large hiatal hernias may cause chronic gastrointestinal blood loss leading to iron deficiency anemia.

Based on their surgical observations, Windsor and Collis in 1967[4] proposed that blood loss was due to local trauma to the stomach where it rides to and fro in the hiatus on respiration.

Boutelier et al.[8] noted on gastroscopy ulcers and erosions at the level of the neck of the hernia in individuals with acute and chronic bleeding, but no detailed description was given.

The lesions were typically white, superficial, linear, and oriented along the crests of inflamed appearing mucosal folds (figure 2).

Anemia in patients with large hernias was corrected by surgical repair in the majority of instances, but Cameron lesions were found in only about half of these individuals.

Sometimes the lesions are found when endoscopy is done for other hernia symptoms than anemia such as heartburn, regurgitation, swallowing difficulty, pain or distention.

[9] When a person with iron deficiency anemia is found to have a large hernia and Cameron lesions on endoscopy, this usually explains the blood loss.

A large hiatal hernia. Two x-rays from the same examination. On lying down (A) more stomach slides above the diaphragm than when upright (B) Note constriction of stomach at diaphragm level.
Cameron lesions. A long linear erosion and smaller non-linear erosions on the crests of inflamed gastric folds at the level of the diaphragm.
Red, congested folds with blood on a Cameron lesion.
After aspirating some air through the endoscope, this lesion was seen rubbing against opposite folds at the diaphragm level on respiration.