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Kong M, Liu W, Bai Y, Jia J, Liu C, Zhang S. Transumbilical single-site laparoscopic treatment of small intestinal cavernous hemangioma in child: a case report. Front Oncol 2024; 14:1360557. [PMID: 38496755 PMCID: PMC10941337 DOI: 10.3389/fonc.2024.1360557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/08/2024] [Indexed: 03/19/2024] Open
Abstract
Background While hemangiomas are the most commonly occurring benign vascular tumors, their occurrence in the gastrointestinal system is rare. This case report presents a unique instance of small intestinal hemangioma in a pediatric patient. Case description A 21-month-old girl was admitted to the hospital with a history of "recurrent blood in the stool for one year and anemia for five months." Upon evaluation at our facility, abdominal color ultrasound and enhanced CT scans revealed a protruding mass in the wall of the small intestine, leading to a preliminary diagnosis of small intestinal hemangioma. Subsequent single-site umbilical laparoscopic exploration identified a tumor measuring approximately 6cm×2.5cm×1.2cm on the jejunum wall. Consequently, segmental resection of the intestine was performed, and the postoperative pathological diagnosis confirmed cavernous hemangioma. Conclusion Small intestinal hemangiomas, particularly in pediatric patients, are exceptionally rare and challenging to diagnose as the cause of gastrointestinal bleeding prior to surgery. Hence, small intestinal hemangiomas should be considered in such cases. Laparoscopic surgical resection emerges as the optimal approach for addressing small intestinal hemangiomas.
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Affiliation(s)
- Meng Kong
- Department of Pediatric Surgery, Children’s Hospital Affiliated to Shandong University, Jinan, China
- Department of Pediatric Surgery, Jinan Children’s Hospital, Jinan, China
| | - Weiqiang Liu
- Department of Pediatric Surgery, Zhucheng Women and Children’s Hospital, Weifang, China
| | - Yuexia Bai
- Department of Pathology, Children’s Hospital Affiliated to Shandong University, Jinan, China
| | - Jinhua Jia
- Department of Pediatric Surgery, Children’s Hospital Affiliated to Shandong University, Jinan, China
- Department of Pediatric Surgery, Jinan Children’s Hospital, Jinan, China
| | - Chuanyang Liu
- Department of Pediatric Surgery, Children’s Hospital Affiliated to Shandong University, Jinan, China
- Department of Pediatric Surgery, Jinan Children’s Hospital, Jinan, China
| | - Shisong Zhang
- Department of Pediatric Surgery, Children’s Hospital Affiliated to Shandong University, Jinan, China
- Department of Pediatric Surgery, Jinan Children’s Hospital, Jinan, China
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Dukmak ON, Ayyad M, Gabajah M, Dabbas F, Budair A, Emar M, Maraqa M, Joubran F. Duodenal Hemangioma as a Rare Cause of Gastrointestinal Bleeding: A Case Report and Literature Review. Cureus 2023; 15:e43293. [PMID: 37692602 PMCID: PMC10492641 DOI: 10.7759/cureus.43293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 09/12/2023] Open
Abstract
Duodenal hemangiomas are benign vascular tumors caused by haphazard vascular proliferation within the duodenal wall. Although rare, duodenal hemangiomas could lead to rapidly progressive life-threatening gastrointestinal (GI) bleeding that requires urgent intervention. The diagnosis of duodenal hemangioma often requires direct visualization of the lesion either endoscopically or surgically, as well as histopathological examination. Treatment options include endoscopic resection, laser coagulation, sclerotherapy, or in a specific subset of patients, open or laparoscopic surgical intervention. We herein report a case of a 46-year-old female presenting with signs and symptoms of chronic GI bleeding. The patient underwent upper endoscopy and was found to have an ulcerated mass in the proximal duodenum consistent with the diagnosis of duodenal hemangioma. This case highlights the importance of including duodenal hemangioma in the differential of upper GI bleeding. It also underscores the significance of surgical intervention in treating duodenal hemangioma, as well as the crucial role of employing endoscopy in the diagnostic and therapeutic management of this condition.
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Yao L, Li LW, Yu B, Meng XD, Liu SQ, Xie LH, Wei RF, Liang J, Ruan HQ, Zou J, Huang JA. Cavernous hemangioma of the ileum in a young man: A case report and review of literature. World J Clin Cases 2022; 10:10146-10154. [PMID: 36246816 PMCID: PMC9561558 DOI: 10.12998/wjcc.v10.i28.10146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/29/2022] [Accepted: 08/22/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Small intestinal cavernous hemangioma is a rare disease, especially in the ileum. It is difficult to accurately diagnose due to its hidden location and nonspecific clinical symptoms. Here, we reported a case of ileal cavernous hemangioma with chronic hemorrhage in a 20-year-old man and review the literature to gain a better understanding of this disease.
CASE SUMMARY The patient complained of intermittent melena and hematochezia for > 3 mo. The lowest hemoglobin level revealed by laboratory testing was 3.4 g/dL (normal range: 12-16 g/dL). However, the gastroscopy, colonoscopy and peroral double-balloon enteroscopy (DBE) showed no signs of bleeding. The transanal DBE detected a lesion at about 340 cm proximal to the ileocecal valve. Thus, we performed an exploratory laparoscopy and the lesion was resected. After the operation, the patient had no melena. Finally, the pathological examination identified the neoplasm as an ileal cavernous hemangioma, thereby resulting in gastrointestinal hemorrhage.
CONCLUSION This report might improve the diagnosis and treatment of ileal cavernous hemangioma.
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Affiliation(s)
- Li Yao
- Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530005, Guangxi Zhuang Autonomous Region, China
| | - Li-Wei Li
- Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530005, Guangxi Zhuang Autonomous Region, China
| | - Bing Yu
- Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530005, Guangxi Zhuang Autonomous Region, China
| | - Xiao-Dan Meng
- Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530005, Guangxi Zhuang Autonomous Region, China
| | - Shi-Quan Liu
- Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530005, Guangxi Zhuang Autonomous Region, China
| | - Li-Hua Xie
- Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530005, Guangxi Zhuang Autonomous Region, China
| | - Rong-Fen Wei
- Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530005, Guangxi Zhuang Autonomous Region, China
| | - Jie Liang
- Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530005, Guangxi Zhuang Autonomous Region, China
| | - Hua-Qiang Ruan
- Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530005, Guangxi Zhuang Autonomous Region, China
| | - Jun Zou
- Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530005, Guangxi Zhuang Autonomous Region, China
| | - Jie-An Huang
- Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530005, Guangxi Zhuang Autonomous Region, China
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Kleinman EP, Blei F, Adams D, Greenberger S. Sirolimus for diffuse intestinal infantile hemangioma with PHACE features: systematic review. Pediatr Res 2022; 93:1470-1479. [PMID: 36180586 DOI: 10.1038/s41390-022-02325-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/01/2022] [Accepted: 09/13/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND We report a 3-month-old female with cardiovascular anomalies and diffuse intestinal infantile hemangioma (IIH) of the small bowel suggesting possible diagnosis of PHACE syndrome (posterior fossa anomalies, hemangioma, arterial lesions, cardiac abnormalities/coarctation of the aorta, eye anomalies). The GI symptoms persisted under treatment with propranolol, whereas the addition of sirolimus led to regression of the IIH. METHODS A systematic review was conducted using PubMed, EMBASE, and Ovid MEDLINE databases between 1982 and 2021. RESULTS A total of 4933 articles were identified; 24 articles met inclusion criteria with 46 IIH cases. The most common GI presentations were unspecified GI bleed (40%) and anemia (38%). The most common treatments were corticosteroids (63%), surgical resection (32.6%), and propranolol (28%). Available outcomes were primarily bleeding arrest (84%). Nine cases (19.5%) were diagnosed with definite PHACE, 5 (11%) with possible PHACE, and 32 (69.5%) no PHACE. Our case presented with symptoms most consistent with those of possible PHACE and definite PHACE. No cases in this review underwent treatment with sirolimus. CONCLUSIONS This is the first reported case of successful treatment of IIH with sirolimus. Our case, along with other patients who present with IIH and PHACE features, suggests consideration of IIH as a diagnostic criterion for PHACE syndrome. IMPACT This is the first reported case in which sirolimus showed regression of an intestinal infantile hemangioma. This study serves to demonstrate the presentation, treatment, outcomes of intestinal infantile hemangioma, and correlation with PHACE. The potential correlation between intestinal infantile hemangioma and PHACE deserves more study in consideration of intestinal infantile hemangioma as a diagnostic criterion of PHACE.
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Affiliation(s)
| | - Francine Blei
- Hassenfeld Children's Hospital, NYU Langone, New York, NY, USA
| | - Denise Adams
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Shoshana Greenberger
- Sackler School of Medicine, Tel Aviv, Israel.,Pediatric Dermatology Service, The Department of Dermatology, Sheba Medical Center, Ramat Gan, Israel
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Singh G, Banerjee R, Varma M, Aggarwal SK, Gupta P. Vascular malformation of ileum: A possible cause of neonatal intestinal obstruction. Ann Med Surg (Lond) 2020; 60:704-707. [PMID: 33425338 PMCID: PMC7779960 DOI: 10.1016/j.amsu.2020.11.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/12/2020] [Accepted: 11/14/2020] [Indexed: 10/27/2022] Open
Abstract
Vascular lesions of gut are rare and they may rarely cause luminal obstruction in neonates. A baby boy born at 36 weeks of gestation presented with small bowel obstruction on day 3 of life. X-ray suggested small bowel obstruction. Contrast enema showed microcolon with multiple filling defects. Exploration revealed thin floppy gut with multiple segments of stenoses and dilatation with surface bluish discoloration but no perforation, two areas were resected. Proximal anastomosis was done and distally a stoma was formed. Histopathology showed vascular malformation in all the layers of gut. The diagnosis was impossible preoperatively and could be established after surgery only.
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Affiliation(s)
- Gaurav Singh
- Department of Pediatric Surgery, Sir Ganga Ram Hospital, New Delhi, India
| | - Rupa Banerjee
- Department of Pediatric Surgery, Sir Ganga Ram Hospital, New Delhi, India
| | - Muni Varma
- Department of Pediatric Surgery, Sir Ganga Ram Hospital, New Delhi, India
| | - Satish K Aggarwal
- Department of Pediatric Surgery, Sir Ganga Ram Hospital, New Delhi, India
| | - Pallav Gupta
- Department of Pathology, Sir Ganga Ram Hospital, New Delhi, India
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ElHassan NO, Gourley GR, Pezeshkmehr A, Greenberg SB, Lewis PS, Lile SA. A Preterm Infant with Abdominal Distension and Bloody Stools. J Pediatr 2019; 205:289-289.e1. [PMID: 30322700 DOI: 10.1016/j.jpeds.2018.09.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 09/07/2018] [Accepted: 09/12/2018] [Indexed: 11/17/2022]
MESH Headings
- Diagnosis, Differential
- Enterocolitis, Necrotizing/complications
- Enterocolitis, Necrotizing/diagnosis
- Enterocolitis, Necrotizing/surgery
- Female
- Gastrointestinal Hemorrhage/diagnosis
- Gastrointestinal Hemorrhage/etiology
- Humans
- Infant
- Infant, Premature
- Infant, Premature, Diseases/diagnosis
- Infant, Premature, Diseases/surgery
- Laparotomy
- Radiography, Abdominal
- Tomography, X-Ray Computed
- Ultrasonography, Doppler
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Affiliation(s)
| | | | - Amir Pezeshkmehr
- Department of Radiology University of Arkansas for Medical Sciences Little Rock, Arkansas
| | - S Bruce Greenberg
- Department of Radiology University of Arkansas for Medical Sciences Little Rock, Arkansas
| | - Paul S Lewis
- Department of Radiology University of Arkansas for Medical Sciences Little Rock, Arkansas
| | - Scott A Lile
- Department of Radiology University of Arkansas for Medical Sciences Little Rock, Arkansas
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Hu PF, Chen H, Wang XH, Wang WJ, Su N, Shi B. Small intestinal hemangioma: Endoscopic or surgical intervention? A case report and review of literature. World J Gastrointest Oncol 2018; 10:516-521. [PMID: 30595805 PMCID: PMC6304305 DOI: 10.4251/wjgo.v10.i12.516] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 11/05/2018] [Accepted: 11/07/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hemangioma of the small intestine is a rare vascular malformation. Before the advent of capsule endoscopy (CE) and balloon-assisted enteroscopy (BAE), preoperative diagnosis of this disease was extremely difficult.
CASE SUMMARY In this study, we report a 24-year-old female with a large transmural small bowel cavernous hemangioma, which was diagnosed with CE and BAE preoperatively and removed successfully using minimally invasive surgery. Meanwhile, we perform a literature review of the studies about intestinal hemangiomas published after 2000. Literature review revealed that 91.9% of the lesions were diagnosed preoperatively by CE and/or BAE and 45.9% of them were treated endoscopically, which is a marked improvement compared to before 2000. Therefore, CE and BAE are useful modalities for the preoperative diagnosis of hemangiomas in the small intestine.
CONCLUSION Endoscopic treatment of intestinal hemangioma is generally prudent and might be suitable for multiple, relatively small lesions.
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Affiliation(s)
- Ping-Fang Hu
- Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
| | - Han Chen
- Department of General Surgery, Hongkou Branch of Changhai Hospital, Second Military Medical University, Shanghai 200081, China
| | - Xiao-Hang Wang
- Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
| | - Wei-Jun Wang
- Department of General Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
| | - Ning Su
- Department of General Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
| | - Bin Shi
- Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
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Destro F, Maestri L, Vella C, Baraldini V, Riccipetitoni G. Infantile hemangioma as cause of neonatal gastrointestinal bleeding. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018. [DOI: 10.1016/j.epsc.2018.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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9
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Kumar N, Adam SZ, Goodhartz LA, Hoff FL, Lo AA, Miller FH. Beyond hepatic hemangiomas: the diverse appearances of gastrointestinal and genitourinary hemangiomas. ACTA ACUST UNITED AC 2016; 40:3313-29. [PMID: 26239397 DOI: 10.1007/s00261-015-0515-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Hemangiomas are common lesions, best known for their appearance in the liver. Their appearance in less common locations, such as the gastrointestinal and genitourinary tracts, is less well known. We will review the typical and atypical appearance of hemangiomas in these locations on sonography, CT, and MRI.
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Affiliation(s)
- Nishant Kumar
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 North Saint Clair St. Suite 800, Chicago, USA
| | - Sharon Z Adam
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 North Saint Clair St. Suite 800, Chicago, USA
| | - Lori A Goodhartz
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 North Saint Clair St. Suite 800, Chicago, USA
| | - Frederick L Hoff
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 North Saint Clair St. Suite 800, Chicago, USA
| | - Amy A Lo
- Department of Pathology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Frank H Miller
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 North Saint Clair St. Suite 800, Chicago, USA.
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Morris GA, Stratchko L, Sabri M. Intestinal hemangioma presenting as recurrent hematochezia in a 6-week-old male. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2015. [DOI: 10.1016/j.epsc.2015.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Successful treatment of visceral infantile hemangioma of the omentum and mesentery with propranolol. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2014. [DOI: 10.1016/j.epsc.2014.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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12
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Shukri N, Amara R, Malik S, Taher H, Kilany M. Neonatal intestinal perforation-a rare complication of small bowel hemangioma. European J Pediatr Surg Rep 2013; 1:30-1. [PMID: 25755946 PMCID: PMC4335917 DOI: 10.1055/s-0033-1337110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 12/04/2012] [Indexed: 11/19/2022] Open
Abstract
Intestinal perforation is an extremely rare complication of hemangioma of the small intestine in the neonatal period. This is a case report of a 27-days-old male infant who presented with signs and symptoms of acute intestinal obstruction. Exploratory laparotomy findings revealed intestinal perforation due to solitary hemangioma in the ileum, which led to obstruction from peritoneal reaction and adhesions. There are two reported cases in the literature presenting with ileal perforation in the pediatric age group, but only one previous report mentioned in the neonatal period. Because there are other more common causes of perforation in the neonatal period, intestinal hemangioma in spite of its rarity should be included in the differential diagnosis.
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Affiliation(s)
- Nasser Shukri
- Department of Pediatric Surgery, Maternity and Children's Hospital, Jeddah, Saudi Arabia
| | - Ridha Amara
- Department of Pediatric Surgery, Maternity and Children's Hospital, Jeddah, Saudi Arabia
| | - Shakeel Malik
- Department of Pediatric Surgery, Maternity and Children's Hospital, Jeddah, Saudi Arabia
| | - Hanan Taher
- Department of Pediatric Surgery, Maternity and Children's Hospital, Jeddah, Saudi Arabia
| | - Mansour Kilany
- Department of Pediatric Surgery, Maternity and Children's Hospital, Jeddah, Saudi Arabia
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