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Cameron lesions
Cameron lesions are linear erosions or ulcerations of the mucosal folds lining the stomach where it is constricted by the thoracic diaphragm in persons with large hiatal hernias.〔Cameron AJ, Higgins JA. Linear gastric erosions. A lesion associated with large diaphragmatic hernia chronic blood loss anemia. Gastroenterology 1986;91:338-42. PMID 3487479〕 The lesions may cause chronic blood loss resulting in iron deficiency anemia; less often they cause acute bleeding. Treatment of anemia with Cameron lesions includes iron supplements and proton-pump inhibitor (PPI) acid suppression. Surgical hernia repair is sometimes needed.
==Hiatal hernia and anemia==
The diaphragm separates the chest from the abdomen. The esophagus (swallowing tube) passes through the hiatal opening in the diaphragm to reach the stomach. With a hiatal hernia, part of the stomach is displaced upwards into the chest (Figure 1). Large hiatal hernias may cause chronic gastrointestinal blood loss leading to iron deficiency anemia. One study in people with hernias showed mean blood loss of 15ml (a tablespoonful) per day in those with anemia, compared to 3 ml per day in those without anemia.〔Holt JM, Mayet FGH, Warner GT, et al. Iron absorption and blood loss in patients with hiatus hernia. British Medical Journal 1968;3:22-25. PMC 1989480〕 In one report 10% of 100 people investigated for iron deficiency anemia had a large hiatal hernia.〔Kerlin P, Reiner R, Davies M, et al. Iron deficiency anemia-a prospective study. Australia and New Zealand Journal of Medicine 1979;9:402-407. PMID 315771〕 A 1967 review found that 20% of 1305 individuals having surgery for hiatal hernia were anemic.〔Windsor CWO, Collis JL. Anemia and hiatus hernia: experience in 450 patients. Thorax 1967;22:73-78. PMC 471591.〕 Cameron in 1976 〔Cameron AJ. Incidence of iron deficiency anemia in patients with large diaphragmatic hernia. Mayo Clinic Proceedings 1976;51:767-769. PMID 1086935〕 compared 259 people with large hiatal hernias visible on chest x-ray with 259 controls without hernias. Present or past anemia, usually with proven iron deficiency, was found in 10.4% of those with hernias, significantly more than 0.4% of controls, p<0.001. Surgical hernia repair usually prevents anemia recurrence; in 2 large series, post-operative follow-up showed anemia had resolved in 71-92% of subjects.〔Carrott PW, Markar SR, Hong J, et al. Iron-deficiency anemia is a common presenting issue with giant paraesophageal hernia and resolves following repair. Journal of Gastrointestinal Surgery 2013;17:858-862 PMID 23515913.〕〔Trastek VF, Allen MS, Deschamps C, et al. Diaphragmatic hernia and associated anemia: response to surgical treatment. Journal of Thoracic and Cardiovascular Surgery 1996;112:1340-1345. PMID 8911332〕 An isotope study showed correction of blood loss after hernia repair.〔 These findings showed that the hernia was the usual cause of the anemia.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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