Gastrointestinal Bleeding in Infantile Hemangioma: A Complication of Segmental, Rather than Multifocal, Infantile Hemangiomas

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• 作者：Beth A. Drolet ; MD¹ ; ^{bdrolet@mcw.edu} ; Elena Pope ; MD³ ; Anna M. Juern ; MD¹ ; Thomas Sato ; MD² ; Brandon Howell ; MD³ ; Katherine Brown Puttgen ; MD⁴ ; Irene Lara-Corrales ; MD³ ; Amy Gilliam ; MD⁵ ; Anthony Mancini ; MD⁶ ; Julie Powell ; MD⁷ ; Dawn Siegel ; MD¹ ; Denise Metry ; MD⁸ ; David A. Stevenson ; MD⁹ ; Johannes F. Grimmer ; MD¹⁰ ; Ilona J. Frieden ; MD¹¹
• 关键词：GLUT-1 ; Glucose transporter 1 ; ICA ; Internal carotid artery ; MLT ; Multifocal lymphangioendotheliomatosis with thrombocytopenia ; MRA ; Magnetic resonance angiography ; MRI ; Magnetic resonance imaging ; PCA ; Posterior communicating artery ; PHACE ; Posterior fos
• 刊名：The Journal of Pediatrics
• 出版年：2012
• 出版时间：June, 2012
• 年：2012
• 卷：160
• 期：6
• 页码：1021-1026.e3
• 全文大小：383 K

文摘

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Objective

To highlight an association of facial segmental hemangiomas with gastrointestinal bleeding in infants with infantile hemangiomas.

Study design

We conducted a multicenter retrospective case series study.

Results

Ten female patients met study inclusion criteria; 8 were Caucasian, 9 had a facial segmental hemangioma, and 9 cases met the diagnostic criteria for definitive posterior fossa malformations, hemangioma, arterial lesions, cardiac anomalies/coarctation of the aorta and eye abnormalities syndrome with abnormalities of the aorta and cerebral arteriopathy. Severe gastrointestinal bleeding requiring blood transfusion occurred in 9 cases, with age at presentation of gastrointestinal bleeding ranging from 8 days to 6 months. When detected, the location of the hemangioma in the small intestine was in the distribution of the superior mesenteric artery. More than one agent was required to control the gastrointestinal bleeding, including oral or intravenous steroids, vincristine, oral propranolol, interferon, and resection of the small intestine. All cases needed ongoing support care with red blood cell transfusions.

Conclusions

Gastrointestinal bleeding is a rare complication of true infantile hemangioma. The segmental pattern of the cutaneous hemangioma associated with gastrointestinal bleeding should suggest a segmental infantile hemangioma of the lower gastrointestinal tract.