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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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(A) The distribution by age, sex and degree of pigmentation of 750 patients suffering from MC. As shown in (A1), women aged 50–59 years old accounted for most of the cases, while the most cases in men were found in the group aged 60–69 years. As shown in (A2), as the degree of pigmentation increased, the percentage of cases decreased. (B) Relationship between the melanosis score and the number of affected segments. The colon was divided into six parts, including the cecum, ascending colon, transverse colon, descending colon, sigmoid colon and rectum. The intensity of melanosis was determined by calculating the sum of the melanosis grades of individual segments. The grade of melanosis in each segment ranged from 0 to 3 according to the degree of pigmentation. As the melanosis score increased, the number of affected segments increased, and the number of patients decreased. Therefore, compared with a few affected segments with severe pathological character, more affected segments with lower grade of melanosis are easier to be seen in the same score of MC. (C) A total of 417 segments were affected by MC in 119 patients. As shown in (C1), the patients included both men and women. Only men are shown in (C2), and only women are shown in (C3). The incidence of affected segments was relatively higher for the ascending colon and transverse colon and lower for the sigmoid colon and rectum in both men and women.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ningning Yang, Mengting Ruan, Shizhu Jin" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Ningning" "apellidos" => "Yang" ] 1 => array:2 [ "nombre" => "Mengting" "apellidos" => "Ruan" ] 2 => array:2 [ "nombre" => "Shizhu" "apellidos" => "Jin" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0210570520300224" "doi" => "10.1016/j.gastrohep.2020.01.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210570520300224?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382420300547?idApp=UINPBA00004N" "url" => "/24443824/0000004300000005/v2_202102251017/S2444382420300547/v2_202102251017/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2444382420300730" "issn" => "24443824" "doi" => "10.1016/j.gastre.2019.10.010" "estado" => "S300" "fechaPublicacion" => "2020-05-01" "aid" => "1462" "copyright" => "Elsevier España, S.L.U." 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"mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 518 "Ancho" => 1500 "Tamanyo" => 102465 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Abdominal CT scan showing ilio-ileal intussusception (arrows) in transverse (A), sagittal (B) and coronal (C) planes, with marked distension of proximal loops and pneumatosis intestinalis (asterisks).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Margarita Fernández-de la Varga, Sergio Béjar-Serrano, Pablo del Pozo-del Valle" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Margarita" "apellidos" => "Fernández-de la Varga" ] 1 => array:2 [ "nombre" => "Sergio" "apellidos" => "Béjar-Serrano" ] 2 => array:2 [ "nombre" => "Pablo" "apellidos" => "del Pozo-del Valle" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210570519302559" "doi" => 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Prida, Benito Hermida Pérez, Zhuraida Salman Monte" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Marta" "apellidos" => "Izquierdo Romero" "email" => array:1 [ 0 => "martaizquierdoromero@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Jorge" "apellidos" => "Rodríguez Prida" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Benito" "apellidos" => "Hermida Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Zhuraida" "apellidos" => "Salman Monte" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Aparato Digestivo, Hospital Universitario de Cabueñes, Gijón, Asturias, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario de Cabueñes, Gijón, Asturias, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Úlceras de Cameron e inhibidores de la recaptación de serotonina: una asociación infrecuente" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 589 "Ancho" => 750 "Tamanyo" => 98396 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Endoscopic image in retroflexion of multiple linear erosions in hernial sac compatible with Cameron lesions.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">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 9.4<span class="elsevierStyleHsp" style=""></span>g/dl, which represents a level of anaemia of up to 4 points with respect to her normal values, and urea 110<span class="elsevierStyleHsp" style=""></span>mg/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 (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Treatment with proton pump inhibitors (PPI) at high doses was started immediately.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">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.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> 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.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> 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.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> It should also be remembered that SSRIs associated with ASA/NSAIDs are an indication for prophylaxis with PPIs.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">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.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 589 "Ancho" => 750 "Tamanyo" => 98396 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Endoscopic image in retroflexion of multiple linear erosions in hernial sac compatible with Cameron lesions.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cameron lesions in patients with hiatal hernias: prevalence, presentation, and treatment, outcome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.M. Gray" 1 => "V. Kushnir" 2 => "G. Kalra" 3 => "A. Rosenstock" 4 => "M.A. Alsakka" 5 => "A. Patel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/dote.12223" "Revista" => array:6 [ "tituloSerie" => "Dis Esophagus" "fecha" => "2015" "volumen" => "28" "paginaInicial" => "448" "paginaFinal" => "452" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24758713" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cameron lesions: a still overlooked diagnosis case report and systematic review of literature" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Zullo" 1 => "R. Manta" 2 => "V. de Francesco" 3 => "G. Fiorini" 4 => "E. Lahner" 5 => "D. Vaira" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clinre.2018.05.002" "Revista" => array:6 [ "tituloSerie" => "Clin Res Hepatol Gastroenterol" "fecha" => "2018" "volumen" => "42" "paginaInicial" => "604" "paginaFinal" => "609" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29910147" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bleeding risk under selective serotonin reuptake inhibitor (SSRI) antidepressants: a meta-analysis of observational studies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Laporte" 1 => "C. Chapelle" 2 => "P. Caillet" 3 => "M.N. Beyens" 4 => "F. Bellet" 5 => "X. Delavenne" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.phrs.2016.08.017" "Revista" => array:6 [ "tituloSerie" => "Pharmacol Res" "fecha" => "2017" "volumen" => "118" "paginaInicial" => "19" "paginaFinal" => "23" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27521835" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/24443824/0000004300000005/v2_202102251017/S2444382420300742/v2_202102251017/en/main.assets" "Apartado" => array:4 [ "identificador" => "75461" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images of the month" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/24443824/0000004300000005/v2_202102251017/S2444382420300742/v2_202102251017/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382420300742?idApp=UINPBA00004N" ]
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