A case report of occult Cameron ulcer and a systematic review of the literature

Background 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. Case presentation A 46-year-old male presented repeatedly with unexplained abdominal pain over a four-year period. A definitive diagnosis of occult Cameron’s ulcer was established through a combination of gastroscopy, abdominal computed tomography (CT), and histopathological analysis. Following proton pump inhibitor (PPI) therapy, the patient’s symptoms showed significant improvement. Discussion 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. Conclusion 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.