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Chen L, Chen F, Jiang T, Deng Y, Shi G. Endoscopic injection of lauromacrogol foam sclerotherapy for rectal cavernous hemangioma: A case report. Medicine (Baltimore) 2024; 103:e38919. [PMID: 38996140 PMCID: PMC11245261 DOI: 10.1097/md.0000000000038919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/14/2024] Open
Abstract
RATIONALE Rectal cavernous hemangioma is a rare, benign vascular disease that seldom causes lower gastrointestinal bleeding, characterized by a high rate of misdiagnosis and missed diagnoses. Surgical treatment is considered to be relatively effective; however, it is accompanied by certain employed in the treatment of superficial hemangioma, boasting the advantages of minimally invasive surgery, including safety, effectiveness, reduced trauma, and rapid recovery. However, there is a lack of literature regarding the application of foam sclerosing agents for gastrointestinal hemangiomas. CASE CONCERNS We present a case of a 60-year-old male who was admitted to our hospital with a history of recurrent hematochezia for >1 year and worsening symptoms for 1 week. The patient's medical history was unremarkable. DIAGNOSES Following colonoscopy, nuclear magnetic resonance imaging, computed tomography, and other examinations, the final diagnosis was rectal cavernous hemangioma. INTERVENTIONS Due to the patient's refusal of surgery, endoscopic foam sclerotherapy using a lauromacrogol injection was performed after obtaining informed consent from the patient and their relatives. OUTCOMES Post-sclerotherapy, hematochezia symptoms ceased, and no adverse reactions were observed. Two months later, colonoscopy and nuclear magnetic resonance imaging showed that the hemangioma had almost completely disappeared, with only a small amount of tumor remnants, yielding a satisfactory curative effect. CONCLUSION Our findings indicate that endoscopic injection of a lauromacrogol foam sclerosing agent is a safe, effective, and minimally invasive treatment option for gastrointestinal cavernous hemangiomas.
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Affiliation(s)
- Ling Chen
- Department of Gastroenterology, Digestive Disease Hospital, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou Province, China
| | - FengYu Chen
- Fenggang County People's Hospital , Fenggang, Guizhou Province, China
| | - Tong Jiang
- Department of Gastroenterology, Digestive Disease Hospital, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou Province, China
| | - Yue Deng
- Department of Gastroenterology, Digestive Disease Hospital, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou Province, China
| | - GuoQing Shi
- Department of Gastroenterology, Digestive Disease Hospital, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou Province, China
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Qin Y, Qiao P, Guan X, Zeng S, Hu XP, Wang B. Successful resection of a huge retroperitoneal venous hemangioma: A case report. World J Clin Cases 2022; 10:9096-9103. [PMID: 36157655 PMCID: PMC9477053 DOI: 10.12998/wjcc.v10.i25.9096] [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: 04/03/2022] [Revised: 06/07/2022] [Accepted: 07/29/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Venous hemangioma is a benign and non-invasive type of tumor, which is rarely identified due to the absence of clinical manifestations. A retroperitoneal benign tumor is comparatively rare, and hemangioma is exceptional. Because of the different types and locations of hemangioma, presentations are varied; thus, establishing an accurate diagnosis before surgery is challenging.
CASE SUMMARY A 45-year-old female patient visited our hospital with the complaint of a retroperitoneal mass without symptoms discovered during a medical examination. An abdominal and pelvic computed tomography (CT) revealed a giant hypodense mass that extended from the lower edge of the liver down to the right groin and showed no marked enhancement in the arterial phase of the enhanced CT. On magnetic resonance imaging, the retroperitoneal mass was hyperintense on the T2-weighted image and hypointense on the T1-weighted image. The mass was completely resected and confirmed as a venous hemangioma by pathology.
CONCLUSION Venous hemangioma is rare in adults, and an accurate diagnosis before surgery is challenging. Surgery is the curative treatment for venous hemangioma, and the definitive diagnosis relies on pathology.
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Affiliation(s)
- Yan Qin
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Peng Qiao
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Xing Guan
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Song Zeng
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Xiao-Peng Hu
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Biao Wang
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
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Ahn WI, Shin JY, Choi JW. [Diffuse Hemangiomatosis in the Intra-Abdominal Cavity Mimicking Peritoneal Metastasis: A Case Report]. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2022; 83:1182-1188. [PMID: 36276213 PMCID: PMC9574286 DOI: 10.3348/jksr.2021.0182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/04/2022] [Accepted: 04/19/2022] [Indexed: 11/15/2022]
Abstract
We call hemangiomatosis if hemangioma arises multifocally from single or multiple organs. It develops predominantly on liver, and there are just few cases of hemangiomatosis from greater omentum and mesentery. Herein, we present the imaging and histopathological findings including CT and MRI images of a 62-year-old male patient with a hemangiomatosis on liver, greater omentum and mesentery.
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Fair L, Gough B, Oknokwo A, Stadler R. A giant hemangioma of the sigmoid colon as a cause of lower gastrointestinal bleeding in a young man. Proc (Bayl Univ Med Cent) 2022; 35:852-853. [DOI: 10.1080/08998280.2022.2101559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Affiliation(s)
- Lucas Fair
- Department of Surgery, Baylor University Medical Center, Dallas, Texas
| | - Benjamin Gough
- Department of Surgery, Baylor University Medical Center, Dallas, Texas
| | - Adatee Oknokwo
- Department of Surgery, Baylor University Medical Center, Dallas, Texas
| | - Ronney Stadler
- Texas Oncology, Division of Texas Colon and Rectal Specialists, Dallas, Texas
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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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Eismontas V, Klimasauskiene V, Dulskas A, Samalavicius NE. Laparoscopic excision of a cystic vascular malformation of the sigmoid colon mesentery presenting as a retroperitoneal tumour - a video vignette. Colorectal Dis 2020; 22:1802-1803. [PMID: 32620029 DOI: 10.1111/codi.15230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 06/14/2020] [Indexed: 02/08/2023]
Affiliation(s)
- V Eismontas
- Klaipeda University Hospital, Klaipeda, Lithuania
| | | | - A Dulskas
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Department of General and Abdominal Surgery and Oncology, National Cancer Institute, Vilnius, Lithuania.,University of Applied Sciences Faculty of Health Care, Vilnius, Lithuania
| | - N E Samalavicius
- Klaipeda University Hospital, Klaipeda, Lithuania.,Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Klaipeda University, Klaipeda, Lithuania
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Numan L, Elkafrawy A, Brotherton T, Tomaw A, Campbell D. Jejunal Submucosal Hemangioma as a Cause of Massive Gastrointestinal Bleeding: A Case Report. Cureus 2020; 12:e8372. [PMID: 32626616 PMCID: PMC7328703 DOI: 10.7759/cureus.8372] [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: 05/13/2020] [Accepted: 05/31/2020] [Indexed: 12/05/2022] Open
Abstract
Small intestinal hemangiomas are uncommon tumors that frequently present with gastrointestinal bleeding (GIB). Diagnosis, detection, and treatment can be challenging and may require surgical intervention. An 81-year-old female presented with melena. Video capsule endoscopy revealed active bleeding in the proximal jejunum and push enteroscopy identified a polypoid nodule with central umbilication. The patient underwent laparoscopic resection and jejunal submucosal hemangioma was detected. Submucosal hemangiomas are a rare cause of GIB. As the most common site of submucosal hemangiomas is the mid-jejunum, they are not easy to detect. Surgical intervention is usually required for a definitive diagnosis and definitive treatment.
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Affiliation(s)
- Laith Numan
- Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, USA
| | - Ahmed Elkafrawy
- Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, USA
| | - Tim Brotherton
- Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, USA
| | - Andrew Tomaw
- Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, USA
| | - Donald Campbell
- Gastroenterology, University of Missouri Kansas City and Saint Luke's Hospital, Kansas City, USA
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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: 11] [Impact Index Per Article: 2.8] [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: 0.5] [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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Rectosigmoidal manifestations of venous malformations: MR imaging findings and interdisciplinary therapeutic modalities. Sci Rep 2019; 9:19916. [PMID: 31882623 PMCID: PMC6934467 DOI: 10.1038/s41598-019-56217-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 12/06/2019] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to identify the frequency of rectosigmoidal involvement in patients with venous malformations (VM) of the lower extremities and to demonstrate multidisciplinary therapeutic options. The medical records and magnetic resonance images (MRI) of patients with VM of the lower extremities, over a six-year period, were reviewed retrospectively in order to determine the occurrence of rectosigmoidal involvement. Vascular interventions, surgical treatments, percutaneous and hybrid (endoscopy-guided angiography) sclerotherapy and procedural complications (according to Clavien-Dindo classification) were also noted. Of the 378 patients with vascular malformation of the lower limbs, 19 patients (5%) had documented venous rectosigmoidal malformation. All of these 19 patients reported episodes of rectal bleeding, while seven patients (36.8%) also had anemia. All patients underwent endoscopy. By endoscopy, seven patients (36.8%) showed discreet changes, and 12 patients (63.2%) showed pronounced signs of submucosal VM with active (47.3%) or previous (15.7%) bleeding. Treatment was performed in all patients with pronounced findings. Six patients underwent endoscopy-guided hybrid sclerotherapy, one patient underwent endoscopic tissue removal, one patient received percutaneous sclerotherapy and one patient received a combination of transvenous embolization and hybrid sclerotherapy. Three patients required open surgery. No complications occurred after conservative treatments; however, one complication was reported after open surgery. None of the treated patients reported further bleeding and anemia at the end of the follow-up period. In this cohort, rectosigmoidal VM occurred in 5% of patients presenting with a high incidence of rectal bleeding. Percutaneous or endoscopy-guided hybrid sclerotherapy appeared to be a safe and effective alternative to surgery.
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Esposito F, Di Serafino M, Severino R, Vafina Z, Ferrara D, Zeccolini M. Mesenteric infantile hemangioma: diagnostic work-up. Quant Imaging Med Surg 2018; 8:252-256. [PMID: 29675365 DOI: 10.21037/qims.2017.09.01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A very rare localization of infantile hemangioma (IH) is mesentery. It may manifest with intra-luminal or intra-peritoneal bleeding. Here there is the case of a 45-day-old infant, presenting with anemia and poor growth, subsequently referred to an uncommon hemangioma of the mesentery. As well as for most of IH, conservative treatment with only propranolol resulted in the disappearance of the lesion. Here we analyze ultrasound and magnetic resonance (MR) features of this uncommon lesion, trying to underline main characteristics at imaging in order to monitor the response to therapy.
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Affiliation(s)
| | - Marco Di Serafino
- Department of Emergency Radiology, San Carlo Hospital, Potenza, Italy
| | - Rosa Severino
- Radiology Department, "Federico II" University Hospital, Napoli, Italy
| | - Zukhra Vafina
- Radiology Department, "Federico II" University Hospital, Napoli, Italy
| | - Dolores Ferrara
- Radiology Department, "Federico II" University Hospital, Napoli, Italy
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