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Chen Z, Wang L, Yu PJ. Early and accurate diagnosis and selection of appropriate treatment plans are crucial for patients with gastrointestinal hemangiomas. World J Gastrointest Surg 2025; 17:99432. [DOI: 10.4240/wjgs.v17.i2.99432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 11/15/2024] [Accepted: 12/03/2024] [Indexed: 01/22/2025] Open
Abstract
Gastrointestinal hemangioma (GIH) is clinically rare, accounting for 7%-10% of benign gastrointestinal tumors and 0.5% of systemic hemangiomas. GIH can occur as either solitary or multiple lesions, with gastrointestinal bleeding as a significant clinical manifestation. Understanding the clinical and endoscopic features of GIH is essential for improving diagnostic accuracy, particularly through endoscopy and selective arteriography, which are highly effective in diagnosing GIH and preventing misdiagnosis and inappropriate treatment. Upon confirmed diagnosis, it is essential to thoroughly evaluate the patient's condition to determine the most suitable treatment modality—whether surgical, endoscopic, or minimally invasive intervention. The minimally invasive interventional partial embolization therapy using polyvinyl alcohol particles, proposed and implemented by Pospisilova et al, has achieved excellent clinical outcomes. This approach reduces surgical trauma and the inherent risks of traditional surgical treatments.
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Affiliation(s)
- Zhou Chen
- Department of Emergency Medicine, The Second Affiliated Hospital of Guangdong University, Zhanjiang 524000, Guangdong Province, China
| | - Liang Wang
- Department of Gastrointestinal Oncology Surgery, Affiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China
| | - Peng-Jie Yu
- Department of Anorectal Surgery, The Affiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China
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2
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Ré F, Carrabetta S, Merlo E, Bisagni P. Multiple Small Bowel Cavernous Hemangiomatosis: Case Report and Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1664. [PMID: 39459451 PMCID: PMC11509273 DOI: 10.3390/medicina60101664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2024] [Revised: 10/02/2024] [Accepted: 10/08/2024] [Indexed: 10/28/2024]
Abstract
A 79 year old female individual presented to the hospital and complained of 1 month melena and anemia due to chronic gastrointestinal bleeding because of cavernous hemangiomatosis of the small bowel. After undergoing an initial video laparoscopic jejunal-ileal resection surgery 7 days after first hospitalization, given the persistence of anemia, she underwent laparotomic duodenojejunal resection surgery again 2 months later. Multiple cavernous hemangiomatosis is a rare vascular disease (7-10% of all benign small bowel tumors), and it often manifests with bleeding, which may be occult or massive; more rarely, it manifests with intestinal occlusion or perforation. Diagnoses often require the use of multiple radiological and endoscopic methods; video capsule endoscopy has significantly increased the diagnostic rate. The gold standard of treatment is surgical resection, whenever possible, balancing the need for radicality with the possible metabolic consequences of massive small intestine resections.
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Affiliation(s)
- Francesca Ré
- General Surgery Department, Villa Scassi, 16149 Genova, Italy; (F.R.); (S.C.)
| | | | - Eugenio Merlo
- Pathology Department, Villa Scassi, 16149 Genova, Italy;
| | - Pietro Bisagni
- General Surgery Department, ASST Lodi—Università Statale di Milano, 20122 Milano, Italy
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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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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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Zhang Y, Wu B. Cavernous hemangioma of the mesorectum involving the rectum: a rare case report. BMC Gastroenterol 2021; 21:378. [PMID: 34654369 PMCID: PMC8518161 DOI: 10.1186/s12876-021-01949-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 09/30/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Gastrointestinal hemangiomas are very rare and are even rarer in the mesorectum. It is not clear whether mesorectal hemangiomas originate in the bowel wall or in the mesorectum. For clinicians, to correctly identify the imaging features of mesorectal hemangiomas is important. CASE PRESENTATION We herein describe a case of a 31-year-old male that presented with hematochezia and sensation of rectal tenesmus. Both the rectal MRI and contrast-enhanced CT scan of the whole abdomen indicated rectal wall thickening, marked dilatation, and tortuous vessels around the rectum. In addition, a contrast-enhanced portal venous phase CT scan showed the dilation of portal vein, splenic vein and inferior mesenteric vein. The dilated inferior mesenteric vein extending down to the mesorectum, and became marked dilatation and tortuous vessels around the rectum. The patient underwent laparoscopic surgical resection of the mesorectal lesion and the involved portions of the rectum. The surgical samples underwent pathological analysis, and a diagnosis of cavernous hemangioma was confirmed. Seven days after surgery, the patient was discharged without postoperative complications. CONCLUSIONS This case highlights the imaging features of mesorectal hemangiomas. In addition, in this current case, the mesorectal hemangioma more likely originated in the mesorectum.
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Affiliation(s)
- Yan Zhang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guoxue Road, Chengdu, 610041, China
| | - Bing Wu
- Department of Radiology, West China Hospital, Sichuan University, 37# Guoxue Road, Chengdu, 610041, China.
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Kano T, Fukai S, Okamoto R, Motomura Y, Lefor AK, Mizokami K. An incidentally identified 15 cm cavernous hemangioma of the small intestine: Case report and literature review. Int J Surg Case Rep 2021; 84:106144. [PMID: 34225061 PMCID: PMC8261649 DOI: 10.1016/j.ijscr.2021.106144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/08/2021] [Accepted: 06/25/2021] [Indexed: 02/07/2023] Open
Abstract
Introduction Hemangiomas of the small intestine are rare, usually present with symptoms such as anemia, gastrointestinal bleeding or abdominal pain and are resected. We report resection of an incidentally identified cavernous hemangioma of the small intestine that did not present symptoms referable to the hemangioma. Although it was a large lesion, it was resected using laparoscopy and a mini-laparotomy. Presentation of case A 29-year-old otherwise healthy man was referred for evaluation of ileal wall thickening found on a contrast-enhanced computed tomography scan obtained for the workup of chronic diarrhea. Double balloon enteroscopy (DBE) showed a cavernous hemangioma of the small intestine. The lesion was 15 cm and resected using laparoscopy and a mini-laparotomy to prevent future bleeding. The histopathological diagnosis was a cavernous hemangioma of the ileum. Discussion Though there have been no reports of the asymptomatic patients of the disease, the recent spread of double balloon enteroscopy and capsule endoscopy will allow us to diagnose more asymptomatic hemangiomas like this patient. Also, this large lesion was able to be resected through a small incision due to its compressible nature. Conclusion Future studies in asymptomatic patients of the disease may help to determine the optimal management for these patients. Even large hemangiomas are compressible, facilitating minimally invasive resection.
Hemangiomas of the small intestine are rare disease. They have always been diagnosed with symptoms such as anemia and bleeding so far. An asymptomatic hemangioma of the small intestine was incidentally identified. It was big, but laparoscopic resection was possible due to its compressible nature. To determine the optimal treatment for asymptomatic lesions is a task in the future.
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Affiliation(s)
- Takeshi Kano
- Department of Surgery, Tokyo Bay Urayasu-Ichikawa Medical Center, 3-4-32 Todaijima, Urayasu, Chiba 279-0001, Japan.
| | - Shota Fukai
- Department of Surgery, Tokyo Bay Urayasu-Ichikawa Medical Center, 3-4-32 Todaijima, Urayasu, Chiba 279-0001, Japan.
| | - Risa Okamoto
- Department of Gastroenterology, Tokyo Bay Urayasu-Ichikawa Medical Center, 3-4-32 Todaijima, Urayasu, Chiba 279-0001, Japan.
| | - Yasuaki Motomura
- Department of Gastroenterology, Tokyo Bay Urayasu-Ichikawa Medical Center, 3-4-32 Todaijima, Urayasu, Chiba 279-0001, Japan.
| | - Alan Kawarai Lefor
- Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan.
| | - Ken Mizokami
- Department of Surgery, Tokyo Bay Urayasu-Ichikawa Medical Center, 3-4-32 Todaijima, Urayasu, Chiba 279-0001, Japan.
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Fu JX, Zou YN, Han ZH, Yu H, Wang XJ. Small bowel racemose hemangioma complicated with obstruction and chronic anemia: A case report and review of literature. World J Gastroenterol 2020; 26:1674-1682. [PMID: 32327915 PMCID: PMC7167414 DOI: 10.3748/wjg.v26.i14.1674] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 03/10/2020] [Accepted: 03/14/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gastrointestinal hemangiomas are rare benign tumors. According to the size of the affected vessels, hemangiomas are histologically classified into cavernous, capillary, or mixed-type tumors, with the cavernous type being the most common and racemose hemangiomas being very rare in the clinic. Melena of uncertain origin and anemia are the main clinical manifestations, and other presentations are rare. Due to the rarity of gastrointestinal hemangiomas and lack of specific manifestations and diagnostic methods, preoperative diagnoses are often delayed or incorrect.
CASE SUMMARY We report a 5-year-old girl who presented with abdominal pain, nausea, and vomiting for a duration of 10 h. The laboratory studies showed prominent anemia. Computed tomography and contrast-enhanced computed tomography of the abdomen revealed a small bowel obstruction caused by a giant abdominal mass. Segmental resection of the ileal lesions was performed through surgery, and the final pathology results revealed a diagnosis of racemose hemangioma complicated by a small bowel obstruction and simultaneous chronic anemia.
CONCLUSION The current report will increase the understanding of the diagnosis and treatment of gastrointestinal hemangiomas and provide a review of the related literature.
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Affiliation(s)
- Ji-Xin Fu
- Department of Gastrointestinal Surgery, Weihai Central Hospital, Weihai 264200, Shandong Province, China
| | - Ya-Nan Zou
- Department of Anesthesiology, Weihai Central Hospital, Weihai 264200, Shandong Province, China
| | - Zhi-Hao Han
- Department of Radiology, Weihai Central Hospital, Weihai 264200, Shandong Province, China
| | - Hao Yu
- Department of Gastrointestinal Surgery, Weihai Central Hospital, Weihai 264200, Shandong Province, China
| | - Xin-Jian Wang
- Department of Gastrointestinal Surgery, Weihai Central Hospital, Weihai 264200, Shandong Province, China
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Wu F, Hu M, Cao M, Ou M, Li Q, Liu Z. Giant Mesenteric Mixed Hemangioma Misdiagnosed as Ovarian Cyst: A Case Report and a Literature Review. Ann Vasc Surg 2020; 67:567.e1-567.e4. [PMID: 32209416 DOI: 10.1016/j.avsg.2020.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 12/22/2022]
Abstract
Hemangiomas are congenital vascular disorders that occur primarily in the face and neck, extremely rare in the mesentery. Here, we report a rare small mesenteric mixed hemangioma. A 34-year-old woman was admitted to the gynecology department for an extended menstrual cycle. A cystic multi-atrial mass at the right anterior of uterus was observed by ultrasound examination, which was about 12.5 × 9.5 × 14.9 cm in size. The gynecologist mostly considered the possibility of the ovarian cyst. However, there was a huge multi-atrial cyst in the small intestine mesentery without the right ovarian cyst in the surgical exploration. The grape-like cystic mass about 15 cm in diameter adhered to the mesenteric root of the small intestine. The cyst was diagnosed as the mesenteric mixed hemangioma in the final histopathology.
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Affiliation(s)
- Feifeng Wu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China
| | - Min Hu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China
| | - Mingrong Cao
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China.
| | - Maoqiang Ou
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China
| | - Qiang Li
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China
| | - Zhilong Liu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China
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Ocampo Toro WA, Corral Ramos B, Concejo Iglesias P, Cubero Carralero J, Blanco García DF, Barón Ródiz P. Haemangiomas of the Small Intestine: Poorly Known Cause of Gastrointestinal Bleeding of Uncertain Origin. Cureus 2018; 10:e3155. [PMID: 30349762 PMCID: PMC6193570 DOI: 10.7759/cureus.3155] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Small bowel haemangiomas are benign vascular tumours that may cause gastrointestinal bleeding of uncertain origin, are frequently chronic, and are rarely acute. We report a case of an haemangioma located in the distal ileum of a 29-year-old male with a history of chronic anemia since childhood. Imaging studies showed a mural thickening in the distal ileum with phleboliths, which is a key finding of haemangioma. Surgery was performed, and histology confirmed the diagnosis.
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Durer C, Durer S, Sharbatji M, Comba IY, Aharoni I, Majeed U. Cavernous Hemangioma of the Small Bowel: A Case Report and Literature Review. Cureus 2018; 10:e3113. [PMID: 30338188 PMCID: PMC6175268 DOI: 10.7759/cureus.3113] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Hemangiomas of the small intestine are rare and very difficult to diagnose preoperatively. Clinical presentations may include occult or massive gastrointestinal (GI) bleeding, obstruction, intussusception, and perforation. We report a 66-year-old Caucasian male patient with severe anemia secondary to occult GI bleeding from a cavernous hemangioma in the jejunum. A double balloon enteroscopy following capsule endoscopy was performed to obtain biopsy samples, which established the final diagnosis.
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Affiliation(s)
- Ceren Durer
- Internal Medicine, Florida Hospital-Orlando, Orlando, USA
| | - Seren Durer
- Internal Medicine, Florida Hospital-Orlando, Orlando, USA
| | | | - Isin Y Comba
- Internal Medicine, UCF Internal Medicine Residency Program, Orlando, USA
| | - Ilan Aharoni
- Gastroenterology, Florida Hospital, Orlando, USA
| | - Umair Majeed
- Internal Medicine Residency, Florida Hospital-Orlando, Casselberry, USA
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