Lee Young Ah, Chun Peter, Hwang Eun Ha, Lee Yeoun Joo, Kim Chang Won, Park Jae Hong
Good Gang-An Hospital, Busan, Korea.
Department of Pediatrics, Pusan National University College of Medicine, Busan, Korea.
Pediatr Gastroenterol Hepatol Nutr. 2017 Jun;20(2):134-137. doi: 10.5223/pghn.2017.20.2.134. Epub 2017 Jun 28.
Gastric hemangioma in the neonatal period is a very rare cause of upper gastrointestinal bleeding. We present a case of hemangioma limited to the gastric cavity in a 10-day-old infant. A huge, erythematous mass with bleeding was observed on the lesser curvature side of the upper part of the stomach. Surgical resection was ruled out because the location of the lesion was too close to the gastroesophageal junction. Medical treatment with intravenous H blockers, octreotide, packed red blood cell infusions, local epinephrine injection at the lesion site, application of hemoclip, and gel-form embolization of the left gastric artery did not significantly alter the transfusion requirement. Hemostasis was achieved with endoscopic argon plasma coagulation (APC). After two sessions of APC, complete removal of the lesion was achieved. APC was a simple, safe and effective tool for hemostasis and the ablation of gastric hemangioma without significant complications.
新生儿期胃血管瘤是上消化道出血非常罕见的病因。我们报告一例10日龄婴儿胃腔内局限性血管瘤病例。在胃上部小弯侧观察到一个巨大的、伴有出血的红斑性肿物。由于病变位置过于靠近胃食管交界处,排除了手术切除。静脉注射H受体阻滞剂、奥曲肽、输注浓缩红细胞、在病变部位局部注射肾上腺素、应用止血夹以及对胃左动脉进行凝胶型栓塞等内科治疗均未显著改变输血需求。通过内镜氩离子凝固术(APC)实现了止血。经过两次APC治疗,病变完全消除。APC是一种简单、安全且有效的止血及胃血管瘤消融工具,且无明显并发症。