A comprehensive endoscopic and clinical evaluation of Cameron ulcers: Insights from a single-center cross-sectional experience

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Abstract
This study aims to provide a comprehensive analysis of the endoscopic and clinical characteristics of Cameron ulcers, focusing on their morphological presentation, associated comorbidities, and therapeutic outcomes in a single-center cohort. This retrospective study evaluated 43 patients diagnosed with Cameron ulcers at our center between January 2020 and October 2024. Data were collected from medical records, endoscopy reports, and imaging. Patients’ demographic, clinical, laboratory, and histopathological parameters were analyzed. Statistical methods were applied to identify significant differences across subgroups. Cameron ulcers were predominantly associated with chronic gastritis (74.4%), followed by chronic gastritis with intestinal metaplasia (9.3%). The mean hiatal hernia size was 4.6 ± 1.8 cm, with larger sizes observed in chronic Helicobacter pylori -related gastritis (5.3 ± 2.1 cm, P = .003). Markers of systemic inflammation (C-reactive protein [CRP]) and iron metabolism (ferritin) demonstrated significant variability among pathology groups, with the chronic inflammation group exhibiting the lowest ferritin levels and highest CRP concentrations ( P < .001 and P = .025, respectively). Gender differences revealed higher ferritin and CRP levels in females, while males presented with elevated aspartate aminotransferase (AST) values. Cameron ulcers represent a multifactorial condition influenced by anatomical variations, chronic inflammation, microbial factors, and systemic iron metabolism. The findings underscore the importance of considering these ulcers in patients with large hiatal hernias presenting with anemia or gastrointestinal bleeding. Further studies are needed to establish standardized diagnostic and treatment protocols.

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