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Inicio Gastroenterología y Hepatología (English Edition) Cameron lesions and selective serotonin reuptake inhibitors: An uncommon combina...
Información de la revista
Vol. 43. Núm. 5.
Páginas 264-265 (mayo 2020)
Vol. 43. Núm. 5.
Páginas 264-265 (mayo 2020)
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Cameron lesions and selective serotonin reuptake inhibitors: An uncommon combination
Úlceras de Cameron e inhibidores de la recaptación de serotonina: una asociación infrecuente
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Marta Izquierdo Romeroa,
Autor para correspondencia
martaizquierdoromero@gmail.com

Corresponding author.
, Jorge Rodríguez Pridab, Benito Hermida Péreza, Zhuraida Salman Montea
a Servicio de Aparato Digestivo, Hospital Universitario de Cabueñes, Gijón, Asturias, Spain
b Servicio de Medicina Interna, Hospital Universitario de Cabueñes, Gijón, Asturias, Spain
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66-year-old female presenting with coffee-ground vomitus and melaena with no other relevant clinical symptoms. Her medical records indicate that she suffers from anxiety with personality disorder treated with fluoxetine and olanzapine. Blood tests showed a haemoglobin level of 9.4g/dl, which represents a level of anaemia of up to 4 points with respect to her normal values, and urea 110mg/dl, with creatinine in normal range. A gastroscopy was performed which revealed a large hiatal hernia with multiple linear erosions compatible with Cameron lesions, with little active bleeding (Fig. 1). Treatment with proton pump inhibitors (PPI) at high doses was started immediately.

Figure 1.

Endoscopic image in retroflexion of multiple linear erosions in hernial sac compatible with Cameron lesions.

(0.09MB).

Cameron lesions are single or multiple lesions of the gastric mucosa that appear in the sac of a hiatal hernia, especially if it is large in size.1 These types of lesions are usually an incidental finding and are an infrequent cause of upper gastrointestinal bleeding with haematimetric or haemodynamic repercussions, which makes them an under-diagnosed entity.2 Selective serotonin reuptake inhibitors (SSRIs) have been traditionally associated with an increased risk of gastrointestinal bleeding; a recent meta-analysis seems to confirm this suspicion, showing an increased risk of bleeding of at least 36% with this group of drugs.3 It should also be remembered that SSRIs associated with ASA/NSAIDs are an indication for prophylaxis with PPIs.

References
[1]
D.M. Gray, V. Kushnir, G. Kalra, A. Rosenstock, M.A. Alsakka, A. Patel, et al.
Cameron lesions in patients with hiatal hernias: prevalence, presentation, and treatment, outcome.
Dis Esophagus, 28 (2015), pp. 448-452
[2]
A. Zullo, R. Manta, V. de Francesco, G. Fiorini, E. Lahner, D. Vaira, et al.
Cameron lesions: a still overlooked diagnosis case report and systematic review of literature.
Clin Res Hepatol Gastroenterol, 42 (2018), pp. 604-609
[3]
S. Laporte, C. Chapelle, P. Caillet, M.N. Beyens, F. Bellet, X. Delavenne, et al.
Bleeding risk under selective serotonin reuptake inhibitor (SSRI) antidepressants: a meta-analysis of observational studies.
Pharmacol Res, 118 (2017), pp. 19-23

Please cite this article as: Izquierdo Romero M, Rodríguez Prida J, Hermida Pérez B, Salman Monte Z. Úlceras de Cameron e inhibidores de la recaptación de serotonina: una asociación infrecuente. Gastroenterol Hepatol. 2020;43:264–265.

Copyright © 2020. Elsevier España, S.L.U.. All rights reserved
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