Small intestinal hemangioma: Endoscopic or surgical intervention? A case report and review of literature

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.

[1]  Nobuhisa Takase,et al.  Preoperative detection and localization of small bowel hemangioma: Two case reports , 2017, World journal of gastroenterology.

[2]  K. Chayama,et al.  Polidocanol injection therapy for small-bowel hemangioma by using double-balloon endoscopy. , 2016, Gastrointestinal endoscopy.

[3]  M. Ohtani,et al.  Preoperative diagnosis of cavernous hemangioma presenting with melena using wireless capsule endoscopy of the small intestine , 2016, Endoscopy International Open.

[4]  T. Tran,et al.  The “Endothelialized Muscularis Mucosae”: A Case Report Describing a Large Cavernous Hemangioma at the Terminal Ileum and a New Histologic Clue for Preoperative Diagnosis from Endoscopic Biopsy , 2015, Case reports in gastrointestinal medicine.

[5]  J. Leighton,et al.  ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding , 2015, The American Journal of Gastroenterology.

[6]  F. Miller,et al.  Beyond hepatic hemangiomas: the diverse appearances of gastrointestinal and genitourinary hemangiomas , 2015, Abdominal Imaging.

[7]  H. Kang,et al.  Single Cavernous Hemangioma of the Small Bowel Diagnosed by Using Capsule Endoscopy in a Child with Chronic Iron-Deficiency Anemia , 2015, Clinical endoscopy.

[8]  Yafei Zhang,et al.  Enteroscopic sclerotherapy in blue rubber bleb nevus syndrome , 2014, Pakistan journal of medical sciences.

[9]  H. Chuang,et al.  Small Bowel Cavernous Hemangioma Complicated with Intussusception: Report of an Extremely Rare Case and Review of Literature , 2015, Indian Journal of Surgery.

[10]  D. Fernandes,et al.  Cavernous hemangioma of small bowel: a rare cause of digestive hemorrhage. , 2014, Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva.

[11]  O. Ersoy,et al.  Cavernous haemangioma of small intestine mimicking gastrointestinal stromal tumour. , 2013, Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology.

[12]  J. Marescaux,et al.  Small bowel exploration and resection using single‐port surgery: a safe and feasible approach , 2013, Colorectal Disease.

[13]  L. Theilmann,et al.  A rare cause of recurrent iron-deficiency anemia: cavernous hemangioma of the small intestine. , 2012, Journal of gastrointestinal and liver diseases : JGLD.

[14]  M. Pera,et al.  Solitary Cavernous Hemangioma of the Small Intestine as the Cause of Long-Standing Iron Deficiency Anemia , 2012, Journal of Gastrointestinal Surgery.

[15]  M. Lombera,et al.  Hemangioma cavernoso gigante del intestino delgado diagnosticado por cápsula endoscópica , 2012 .

[16]  G. Papachristou,et al.  A case of obscure gastrointestinal bleeding. , 2012, Gastroenterology.

[17]  J. Pence,et al.  Diffuse infantile hemangiomatosis of the ileum presenting with multiple perforations: a case report and review of the literature. , 2010, Journal of pediatric surgery.

[18]  T. Ogihara,et al.  Jejunal capillary hemangioma treated by using double-balloon endoscopy (with video). , 2010, Gastrointestinal endoscopy.

[19]  N. Toubia,et al.  Hemangioma of the small intestine presenting with recurrent overt, obscure gastrointestinal bleeding. , 2010, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[20]  Chien-Huan Chen,et al.  Profound iron deficiency anemia caused by a small-intestinal cavernous hemangioma. , 2009, Gastrointestinal endoscopy.

[21]  E. Ng,et al.  BLUE RUBBER BLEB NEVUS SYNDROME: TREATMENT OF MULTIPLE GASTROINTESTINAL HEMANGIOMAS WITH ARGON PLASMA COAGULATOR , 2009, Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society.

[22]  A. Chong,et al.  Multiple cavernous hemangiomas with iron deficiency anemia successfully treated with double-balloon enteroscopy. , 2008, Gastrointestinal endoscopy.

[23]  R. Pinho,et al.  Solitary hemangioma of the small bowel disclosed by wireless capsule endoscopy. , 2008, Gastroenterologie clinique et biologique.

[24]  W. Law Cavernous hemangioma: uncommon cause of obscure gastrointestinal bleeding. , 2007, Journal of the American College of Surgeons.

[25]  Y. Avni,et al.  Clinical challenges and images in GI. Capillary hemangioma of small intestine. , 2007, Gastroenterology.

[26]  J. Arnaud,et al.  Small bowel cavernous hemangioma: wireless capsule endoscopy diagnosis of a surgical case. , 2007, Gastrointestinal endoscopy.

[27]  A. Magnano,et al.  Solitary hemangioma of the small intestine: an unusual cause of bleeding diagnosed at capsule endoscopy. , 2005, Journal of pediatric surgery.

[28]  J. Barkin,et al.  Small bowel cavernous hemangioma. , 2004, Gastrointestinal endoscopy.

[29]  A. Ginsberg,et al.  Case Report: Giant Mesenteric Hemangioma with Small Intestinal Involvement An Unusual Cause of Recurrent Gastrointestinal Bleed and Review of Gastrointestinal Hemangiomas , 1999, Digestive Diseases and Sciences.