{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T15:20:55Z","timestamp":1767453655257,"version":"3.44.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006190","name":"Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006190","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Cameron ulcer is a rare condition characterized by ulceration within a large hiatal hernia. Numerous studies have reported that Cameron ulcers are typically detected due to complications such as gastrointestinal bleeding or chronic iron deficiency anemia. However, diagnosis based solely on recurrent abdominal pain is exceedingly rare.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A 46-year-old male presented repeatedly with unexplained abdominal pain over a four-year period. A definitive diagnosis of occult Cameron\u2019s ulcer was established through a combination of gastroscopy, abdominal computed tomography (CT), and histopathological analysis. Following proton pump inhibitor (PPI) therapy, the patient\u2019s symptoms showed significant improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>We report the first documented case of an occult Cameron ulcer presenting exclusively with recurrent abdominal pain. In addition, we conducted a comprehensive literature review of previously reported cases of Cameron ulcers. Clinicians should maintain a high index of suspicion for Cameron ulcer in middle-aged and elderly women with hiatal hernia who present with chronic iron deficiency anemia or upper gastrointestinal bleeding. For the diagnosis of occult Cameron ulcers, the integration of gastroscopy, abdominal CT, and histopathological analysis significantly enhances diagnostic accuracy. While the majority of Cameron ulcers respond well to medical management, including acid suppression therapy and iron supplementation, individualized surgical intervention should be considered for patients with severe or refractory complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For patients presenting solely with abdominal pain and suspected Cameron ulcers, we recommend the integrated use of gastroscopy, abdominal CT, and histopathological examination to enhance diagnostic accuracy. In cases with associated complications, a tailored, individualized treatment strategy should be formulated based on clinical presentation and severity.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1677344","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T05:43:53Z","timestamp":1758087833000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["A case report of occult Cameron ulcer and a systematic review of the literature"],"prefix":"10.3389","volume":"12","author":[{"given":"Wei-Feng","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Ping","family":"Lei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi-Qiu","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Lv","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Dong","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/0016-5085(86)90566-4","article-title":"Linear gastric erosion. A lesion associated with large diaphragmatic hernia and chronic blood loss anemia","volume":"91","author":"Cameron","year":"1986","journal-title":"Gastroenterology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1055\/s-0032-1326294","article-title":"Severe upper gastrointestinal hemorrhage from linear gastric ulcers in large hiatal hernias: a large prospective case series of Cameron ulcers","volume":"45","author":"Camus","year":"2013","journal-title":"Endoscopy"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1097\/SMJ.0b013e31820c018c","article-title":"Clinical characteristics and evaluation of patients with large hiatal hernia and Cameron lesions","volume":"104","author":"Yakut","year":"2011","journal-title":"South Med J"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e65510","DOI":"10.7759\/cureus.65510","article-title":"A case of Cameron lesions: an overlooked cause of Anemia in patients with gastrointestinal bleeding and hiatal hernia","volume":"16","author":"Le","year":"2024","journal-title":"Cureus."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"639","DOI":"10.22088\/cjim.13.3.639","article-title":"Cameron lesion with severe iron deficiency anemia and review of literature","volume":"13","author":"Singhai","year":"2022","journal-title":"Casp J Intern Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"103469","DOI":"10.1016\/j.amsu.2022.103469","article-title":"Overt GI bleeding from a Cameron lesion in an Ethiopian with NSAID use: case report of an unusual condition","volume":"75","author":"Seid","year":"2022","journal-title":"Ann Med Surg (Lond)"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"737","DOI":"10.17235\/reed.2021.8000\/2021","article-title":"Hiatal hernia and Cameron ulcer: an overlooked association in pediatric patients","volume":"113","author":"Silva","year":"2021","journal-title":"Rev Esp Enferm Dig"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e928021","DOI":"10.12659\/AJCR.928021","article-title":"A 61-year-old woman with chronic Iron-deficiency Anemia due to a Cameron lesion and a response to Oral application of combined Poloxamer 407 with hyaluronic acid and chondroitin sulfate following single treatment with pantoprazole: a case report","volume":"22","author":"Iliev","year":"2021","journal-title":"Am J Case Rep"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1016\/j.gastrohep.2019.11.007","article-title":"Cameron lesions and selective serotonin reuptake inhibitors: an uncommon combination","volume":"43","author":"Romero","year":"2020","journal-title":"Gastroenterol Hepatol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e7644","DOI":"10.7759\/cureus.7644","article-title":"Cameron ulcers: rare case of overt upper gastrointestinal bleed in a patient with alcohol use disorder","volume":"12","author":"Mehershahi","year":"2020","journal-title":"Cureus"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e00308","DOI":"10.14309\/crj.0000000000000308","article-title":"Large Cameron ulcer bleed","volume":"7","author":"Jabak","year":"2020","journal-title":"Acg Case Rep J"},{"key":"ref12","first-page":"398","article-title":"Life-threatening bleeding for a large Cameron ulcer. A novel description of a tailored-surgical strategy: report of a case and literature overview","volume-title":"G Chir","author":"Bisogni","year":"2019"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1016\/j.clinre.2018.05.002","article-title":"Cameron lesions: a still overlooked diagnosis. Case report and systematic review of literature","volume":"42","author":"Zullo","year":"2018","journal-title":"Clin Res Hepatol Gas"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"733","DOI":"10.12659\/ajcr.894145","article-title":"Cameron ulcer causing severe Anemia in a patient with diaphragmatic hernia","volume":"16","author":"Gupta","year":"2015","journal-title":"Am J Case Rep."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1159\/000144281","article-title":"Cameron lesions: unusual cause of gastrointestinal bleeding and anemia","volume":"77","author":"Maganty","year":"2008","journal-title":"Digestion"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"423","DOI":"10.2298\/mpns1006423j","article-title":"Cameron lesion: an unusual cause of anemia","volume":"63","author":"Jovanovi\u0107","year":"2010","journal-title":"Med Pregl"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"3450","DOI":"10.1007\/s10620-011-1803-y","article-title":"Cameron ulcers: you will find only what you seek","volume":"56","author":"Chun","year":"2011","journal-title":"Digest Dis Sci"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"S285","DOI":"10.14309\/00000434-201210001-00688","article-title":"Cameron ulcers: an atypical source for a massive upper gastrointestinal bleed","volume":"107","author":"Kapadia","year":"2012","journal-title":"Am J Gastroenterol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1177\/1066896912446947","article-title":"Histopathological characterization of a Cameron lesion","volume":"20","author":"Katz","year":"2012","journal-title":"Int J Surg Pathol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"7154","DOI":"10.1007\/s00464-020-08135-w","article-title":"Surgical management of hiatal hernia vs medical therapy to treat bleeding Cameron lesions: a systematic review and meta-analysis","volume":"35","author":"Verhoeff","year":"2020","journal-title":"Surg Endosc"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1016\/j.jad.2025.03.085","article-title":"Acid reflux medication use among adults with depressive symptoms","volume":"379","author":"Meshkat","year":"2025","journal-title":"J Affect Disorders"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e83653","DOI":"10.7759\/cureus.83653","article-title":"Evidence-based review by a multidisciplinary team of pediatricians on the use of gastric acid-reducing medications in children: Indian perspectives","volume":"17","author":"Pai","year":"2025","journal-title":"Cureus"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1097\/MCC.0000000000001251","article-title":"Pharmacological prevention of gastrointestinal bleeding in critically ill patients","volume":"31","author":"Wong","year":"2025","journal-title":"Curr Opin Crit Care"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"2863","DOI":"10.1111\/j.1572-0241.2001.04239.x","article-title":"Mallory-Weiss tear: predisposing factors and predictors of a complicated course","volume":"96","author":"Kortas","year":"2001","journal-title":"Am J Gastroenterol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"265","DOI":"10.30574\/gscarr.2025.23.3.0177","article-title":"Diagnosis and management of Mallory Weiss syndrome","volume":"23","author":"Sucipta","year":"2025","journal-title":"GSC Adv Res Rev"},{"key":"ref26","first-page":"13","article-title":"Surgical treatment of duodenal ulcer associated with Mallory-Weiss syndrome and sliding hiatal hernia and complicated by hemorrhage","volume-title":"Klin Khir","author":"Za\u012dtsev","year":"1997"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e246496","DOI":"10.1136\/bcr-2021-246496","article-title":"Black oesophagus, upside-down stomach and Cameron lesions: cascade effects of a large hiatal hernia","volume":"14","author":"Deliwala","year":"2021","journal-title":"BMJ Case Rep"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"267","DOI":"10.5009\/gnl.2011.5.3.267","article-title":"Clinical significance of hiatal hernia","volume":"5","author":"Hyun","year":"2011","journal-title":"Gut Liver"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1677344\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T05:43:54Z","timestamp":1758087834000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1677344\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,17]]},"references-count":28,"alternative-id":["10.3389\/fmed.2025.1677344"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1677344","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,17]]},"article-number":"1677344"}}