Severe upper gastrointestinal hemorrhage from linear gastric ulcers in large hiatal hernias: a large prospective case series of Cameron ulcers

Endoscopy. 2013;45(5):397-400. doi: 10.1055/s-0032-1326294. Epub 2013 Apr 24.


We report a case series of all consecutive patients hospitalized in our two tertiary referral medical centers over the past 17 years for Cameron ulcers causing severe upper gastrointestinal hemorrhage (GIH) or severe obscure GIH. Cameron ulcers were diagnosed in 25 of the 3960 screened patients with severe upper GIH or severe obscure GIH (0.6 %). Of these, 21 patients had a prospective follow-up (median time 20.4 months [interquartile range: 8.5 - 31.8]). Patients were more often elderly women with chronic anemia, always had large hiatal hernias, and were usually referred for obscure GIH. Twelve of the 21 patients (57 %) were referred for surgery while being treated with high-dose proton pump inhibitors (PPIs). The other 9 patients (43 %) continued PPIs without any rebleeding during the follow-up. Cameron ulcers in large hiatal hernias are an uncommon cause of severe upper GIH. The choice of medical vs. surgical therapy should be individualized.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anemia / drug therapy
  • Anemia / etiology
  • Female
  • Fundoplication
  • Gastrointestinal Hemorrhage / etiology*
  • Gastrointestinal Hemorrhage / therapy*
  • Gastropexy
  • Gastroscopy
  • Hernia, Hiatal / complications*
  • Hernia, Hiatal / therapy*
  • Humans
  • Intention to Treat Analysis
  • Iron / therapeutic use
  • Male
  • Middle Aged
  • Proton Pump Inhibitors / therapeutic use
  • Recurrence
  • Stomach Ulcer / complications*
  • Stomach Ulcer / therapy*


  • Proton Pump Inhibitors
  • Iron