Small bowel racemose hemangioma complicated with obstruction and chronic anemia: A case report and review of literature

Table 1 Gastrointestinal hemangiomas reported in the literature between 2009 and 2019

Ref.	Age (yr)	Sex	Presentation	Preoperative diagnosis study	Hemangioma size (cm)	Location	Histology	Treatment
Attash et al[9]	3	M	Hematemesis, anemia	EGD, CECT	17.6 × 13.2	Stomach	Cavernous	Resembling sleeve gastrectomy
Peng et al[10]	47	M	Fatigue, dizziness, melena	VCE, CECT	50 × 15	Ileum	Cavernous	Partial small bowel resection
Ocampo et al[11]	29	M	Anemia	Abdominal X-ray, CECT	10	Ileum	ND	Segmental small bowel resection
Kaya et al[12]	2 d	F	Melena	EGD	ND	Stomach	ND	Propranolol
Fernandes et al[13]	56	F	Hematochezia, dizziness	VCE, VECT	14	Ileum	Cavernous	Laparotomy and vascular tumor resection
Durer et al[14]	66	M	Anemia	VCE, DBE	2.5	Jejunum	Cavernous	Surgery
Amati et al[15]	20	F	Abdominal distention, pain	CT	28 × 26 × 12	Sigmoid colon	Cavernous	Resection of the sigmoid
Wang et al[16]	73	M	Melena, weakness, dizziness	VCE, DBE	2 × 1	Ileum	Capillary	Laparotomy
Andrade et al[17]	44	F	Melena	Colonoscopy, MRI	7.5 × 3.5	Rectal	ND	Managed conservatively
Li et al[18]	68	M	Epigastric discomfort	EUS, CECT	4 × 2	Stomach	Hemolymphangioma	Endoscopic ultrasonogra-phy treatment
Iwaya et al[19]	70	M	Anemia, melena	VCE, DBE	2 × 1.7 × 1.2	Jejunum	Hemangiolymphangioma	Laparoscopic small bowel resection
Vitor et al[20]	18	M	Melena	Colonoscopy, MRI	ND	Rectum	Cavernous	Iron supplementat-ion
Parker et al[21]	32	M	Abdominal pain, anorexia, constipation	CT biopsy, MRI	14 × 7 × 7	Ileum	Cavernous	Laparotomy
Ganesananthan et al[22]	65	M	Rectal bleeding	Colonoscopy, CT	ND	Left colon and rectum	Cavernous	Managed Conservatively
Takase et al[23]	62	M	Anemia, melena	VCE, DBE	1.5	Jejunum	Cavernous	Laparoscopic enterectomy
	52	M	Anemia	CECT, VCE, DBE	1	Ileum	Cavernous	Laparoscopic enterectomy
Kuo et al[24]	20	F	Lower abdominal pain, postprandial bloating	CECT	5.6 × 4.6 × 1.5	Jejunum	Cavernous	Segmental resection
Zhang et al[25]	44	M	Melena	VCE	ND	Jejunum	Cavernous	Laparotomy with segmental resection
Moein Jahromi et al[26]	75	F	Anemia, melena	VCE, DBE	2.7 × 1.7	Jejunum	Capillary	Laparoscopic partial small bowel resection
Fu et al[27]	54	F	Painless rectal bleeding	Colonoscopy, CT, MRI	ND	Rectum	Cavernous	3-D laparoscopica-lly assisted surgery
	22	F	Recurrent intermittent rectal bleeding	Colonoscopy, CT	ND	Rectum	Cavernous	3-D laparoscopica-lly assisted surgery
Liao et al[28]	11	F	Hematochezia, palpitation, cold sweat	Angiography	1.2 × 1.0	Jejunum	Capillary	Laparoscopic segmental resection
Hu et al[29]	31	F	Melena, dizziness	Angiography	0.3 × 0.3	Jejunum	Racemose hemangioma	Laparoscopic segmental resection
Lian et al[30]	57	M	Abdominal pain with anus exhausting and defecating	CT	16 × 12 × 8	Jejunum	Cavernous	Reduction of the volvulus and segmental resection
Li et al[31]	54	F	Hematemesis, melena, dizziness	EGD, CECT	2 × 2 × 2	Stomach	Racemose hemangioma	Local excision of lesion

ND: Not described; VCE: Video capsule endoscopy; DBE: Double-balloon enteroscopy; CT: Computed tomography; MRI: Magnetic resonance imaging; EUS: Endoscopic ultrasonography; CECT: Contrast-enhanced computed tomography; EGD: Esophagogastroduodenoscopy.

Table 2 Clinicopathological features of gastrointestinal hemangiomas

No. of cases	25
Age	42.92 ± 22.75 (0-75)	Preoperative diagnosis study
Sex		CT or CECT	14 (56%)
Male	14 (54%)	Colonoscopy, EGD, or EUS	9 (36%)
Female	11 (44%)	VCE	9 (36%)
Location		DBE	6 (24%)
Jejunum	9 (36%)	MRI	4 (16%)
Ileum	6 (24%)	Angiography	2 (8%)
Colorectum	6 (24%)	Abdominal X-ray	1 (4%)
Stomach	4 (16%)	Histology
Size	7.44 ± 8.601 (0.3-32.5)	Cavernous hemangioma	15 (68.2%)
Main symptom		Capillary hemangioma	3 (13.7%)
Melena	11 (44%)	Racemose hemangioma	2 (9.1%)
Anemia	7 (28%)	Hemolymphangioma	1 (4.5%)
Dizziness	5 (20%)	Hemangiolymphangioma	1 (4.5%)
Abdominal distention or pain	5 (20%)	Treatment
Rectal bleeding or Hematochezia	5 (20%)	Operation	20 (80%)
Hematemesis	2 (8%)	Endoscopy	1 (4%)
Fatigue or weakness	2 (8%)	Medication (propranolol)	1 (4%)
Anorexia or postprandial bloating	2 (8%)	Iron supplementation	1 (4%)
Palpitations or cold sweat	1 (4%)	None	2 (8%)
Anus exhausting and defecating	1 (4%)

¹The size was the average value of the longitudinal, transverse, and axial lengths of the tumor.