Open AccessC ameron lesions in patients with hiatal hernias: prevalence, presentation, and treatment outcome
Author(s) -
Gray D. M.,
Kushnir V.,
Kalra G.,
Rosenstock A.,
Alsakka M. A.,
Patel A.,
Sayuk G.,
Gyawali C. P.
Publication year - 2015
Publication title -
diseases of the esophagus
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 63
eISSN - 1442-2050
pISSN - 1120-8694
DOI - 10.1111/dote.12223
Subject(s) - medicine , hiatal hernia , retrospective cohort study , occult , epidemiology , cohort , univariate analysis , endoscopy , logistic regression , surgery , gastroenterology , multivariate analysis , pathology , disease , alternative medicine , reflux
Summary C ameron lesions, as defined by erosions and ulcerations at the diaphragmatic hiatus, are found in the setting of gastrointestinal ( GI ) bleeding in patients with a hiatus hernia ( HH ). The study aim was to determine the epidemiology and clinical manifestations of C ameron lesions. We performed a retrospective cohort study evaluating consecutive patients undergoing upper endoscopy over a 2‐year period. Endoscopy reports were systematically reviewed to determine the presence or absence of C ameron lesions and HH . Inpatient and outpatient records were reviewed to determine prevalence, risk factors, and outcome of medical treatment of C ameron lesions. Of 8260 upper endoscopic examinations, 1306 (20.2%) reported an HH . When categorized by size, 65.6% of HH were small (<3 cm), 23.0% moderate (3–4.9 cm), and 11.4% were large (≥5 cm). Of these, 43 patients (mean age 65.2 years, 49% female) had C ameron lesions, with a prevalence of 3.3% in the presence of HH . Prevalence was highest with large HH (12.8%). On univariate analysis, large HH , frequent non‐steroidal anti‐inflammatory drug ( NSAID ) use, GI bleeding (both occult and overt), and nadir hemoglobin level were significantly greater with C ameron lesions compared with HH without C ameron lesions ( P ≤ 0.03). Large HH size and NSAID use were identified as independent risk factors for C ameron lesions on multivariate logistic regression analysis. C ameron lesions are more prevalent in the setting of large HH and NSAID use, can be associated with GI bleeding, and can respond to medical management.