Gastrointestinal bleeding in infantile hemangioma: A complication of segmental, rather than multifocal, infantile hemangiomas

Beth A. Drolet*, Elena Pope, Anna M. Juern, Thomas Sato, Brandon Howell, Katherine Brown Puttgen, Irene Lara-Corrales, Amy Gilliam, Anthony Mancini, Julie Powell, Dawn Siegel, Denise Metry, David A. Stevenson, Johannes F. Grimmer, Ilona J. Frieden

*Corresponding author for this work

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1021-1026.e3
JournalJournal of Pediatrics
Volume160
Issue number6
DOIs
StatePublished - Jun 2012

Keywords

  • Frontotemporal region of face
  • GLUT-1
  • Glucose transporter 1
  • ICA
  • Internal carotid artery
  • MLT
  • MRA
  • MRI
  • Magnetic resonance angiography
  • Magnetic resonance imaging
  • Mandibular region of face
  • Maxillary region of face
  • Multifocal lymphangioendotheliomatosis with thrombocytopenia
  • PCA
  • PHACE
  • Posterior communicating artery
  • Posterior fossa malformations, hemangioma, arterial lesions, cardiac anomalies/coarctation of the aorta and eye abnormalities
  • S1
  • S2
  • S3

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Drolet, B. A., Pope, E., Juern, A. M., Sato, T., Howell, B., Puttgen, K. B., Lara-Corrales, I., Gilliam, A., Mancini, A., Powell, J., Siegel, D., Metry, D., Stevenson, D. A., Grimmer, J. F., & Frieden, I. J. (2012). Gastrointestinal bleeding in infantile hemangioma: A complication of segmental, rather than multifocal, infantile hemangiomas. Journal of Pediatrics, 160(6), 1021-1026.e3. https://doi.org/10.1016/j.jpeds.2011.12.026