Xie Tian, Long Yi
Department of Children's Medical Center, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China.
Front Pediatr. 2025 Sep 12;13:1654913. doi: 10.3389/fped.2025.1654913. eCollection 2025.
A cavernous hemangioma in the small intestine is rare. Due to its hidden location and non-specific clinical symptoms, it is difficult to diagnose accurately. Here, we describe a 14-year-old boy with a cavernous hemangioma and bleeding at the junction of the jejunum and ileum.
The patient presented with clinical manifestations including melena, dizziness, fatigue, pale complexion, and shock. Abdominal contrast-enhanced computed tomography identified a hyperdense lesion within the small bowel lumen. Digital subtraction angiography (DSA) revealed aneurysmal changes in the mid-to-lower abdominal branches of the ileojejunal artery, which were suggestive of a hemorrhage originating from a small intestinal hemangioma. However, subsequent DSA-guided interventional embolization failed to achieve hemostasis. Following a hospital-wide multidisciplinary consultation, a laparoscopic exploration was conducted. During the procedure, a 1.5 cm × 1.5 cm mass was detected at the ileojejunal junction and successfully resected. The postoperative pathological examination confirmed the lesion to be a cavernous hemangioma. One week after surgery, the patient's hemoglobin level increased to 86 g/L, with no recurrence of bloody stools. At the 1-month follow-up, no signs of disease recurrence were observed.
This case report presents significant clinical implications for the diagnosis and management of small intestinal cavernous hemangiomas in the pediatric population.
小肠海绵状血管瘤较为罕见。因其位置隐匿且临床症状不具特异性，故难以准确诊断。在此，我们描述一名14岁患有空肠与回肠交界处海绵状血管瘤并出血的男孩。
患者出现黑便、头晕、乏力、面色苍白及休克等临床表现。腹部增强CT检查发现小肠腔内有一高密度病灶。数字减影血管造影（DSA）显示回结肠动脉中下腹分支有动脉瘤样改变，提示出血源于小肠血管瘤。然而，随后在DSA引导下的介入栓塞未能止血。经全院多学科会诊后，进行了腹腔镜探查。术中，在回结肠交界处发现一个1.5 cm×1.5 cm的肿块，并成功切除。术后病理检查证实该病变为海绵状血管瘤。术后一周，患者血红蛋白水平升至86 g/L，未再出现血便。在1个月的随访中，未观察到疾病复发迹象。
本病例报告对儿科人群小肠海绵状血管瘤的诊断和治疗具有重要临床意义。
