SHM Converge Scientific Abstract ePoster Gallery-The Hernia That Bled in Silence: An Overlooked Cause of Recurrent Iron Deficiency Anemia

Pdf Summary

This case highlights Cameron lesions as an underrecognized cause of chronic blood loss and iron deficiency anemia (IDA), especially in postmenopausal patients with large hiatal hernias. Cameron lesions are linear erosions at the diaphragmatic hiatus caused by mechanical trauma, and they may be missed on initial endoscopy or develop as the hernia enlarges.<br /><br />A 72-year-old woman had recurrent symptomatic IDA requiring multiple hospital admissions, blood transfusions, and outpatient iron infusions despite proton pump inhibitor therapy. Three years earlier, EGD showed a 5 cm hiatal hernia without Cameron lesions, and colonoscopy was unremarkable. During the current admission, her hemoglobin was 6–7 g/dL, again requiring transfusion. Repeat EGD revealed that the hiatal hernia had enlarged to 10 cm and showed linear erosions consistent with Cameron lesions.<br /><br />Management included continued PPI therapy and iron supplementation, with surgical repair considered because of the large hernia and persistent anemia. The report emphasizes that in patients with refractory or transfusion-dependent IDA, especially after malignancy and other sources of bleeding have been excluded, repeat endoscopy should be pursued. Cameron lesions should remain on the differential diagnosis when prior GI evaluations are negative but anemia persists.

Asset Subtitle

Isabella Nieto

Meta Tag

Author List Isabella Nieto, Laith Allaham, Rajesh Metuku, Sushma Nakka

Category Clinical Vignettes

Concept Cameron Lesions

Concept Iron Deficiency Anemia

Concept Hiatal Hernia

Concept Chronic Gastrointestinal Blood Loss

Concept Refractory Iron Deficiency Anemia

Distinguished Non-Finalist

Presenter Organization Lakeland Regional Health.

Presenting Author Isabella Nieto

Track Adult

Keywords

Cameron lesions

iron deficiency anemia

hiatal hernia

chronic blood loss

postmenopausal patient

endoscopy

gastrointestinal bleeding

proton pump inhibitor

blood transfusion

surgical repair

Cameron Lesions

Iron Deficiency Anemia

Hiatal Hernia

Chronic Gastrointestinal Blood Loss

Refractory Iron Deficiency Anemia