Congenital hepatic hemangioma presenting with neonatal intestinal obstruction: A case report

Sumaira Noor Maham,Shabbir Ahmad,Nabila Talat,Muhammad Jawad Afzal

doi:10.47338/jns.v10.948

Sumaira Noor Maham, Shabbir Ahmad + Show 2 more

Open Access

https://doi.org/10.47338/jns.v10.948

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Abstract

Background: Congenital hepatic hemangioma usually presents with abdominal distension. Rarely it may cause intestinal obstruction. We present a case of congenital hepatic hemangioma causing neonatal intestinal obstruction. Case Presentation: A 4-day-old neonate presented with clinical and radiological features of neonatal intestinal obstruction. On exploration, a loop of jejunum was found adherent with a hepatic mass, arising from the left lobe of the liver. The hepatic mass profusely bled in an attempt of removing the adherent jejunal loop. Thus, the adherent portion was isolated and jejunojejunal end to end anastomosis was done. The hepatic mass along with an adherent small piece of jejunum was also excised. Histopathology showed hepatic hemangioma. The patient is doing fine on the 10-month follow-up. Conclusion: We report a rare presentation of congenital hepatic hemangioma with neonatal intestinal obstruction. Although the optimum therapy for hepatic hemangioma is medical management, at times, surgical resection becomes a necessary option.

Highlights

Congenital hemangioma is “Hemangioma with inutero proliferation period, fully formed at birth “(ISSVA classification).[1]
The hepatic hemangioma may present with vomiting and gastric outlet obstruction.[3]
Hemangioma presenting as a gastric outlet and duodenal obstruction has been reported in the literature.[4,5]

Summary

Introduction

Congenital hemangioma is “Hemangioma with inutero proliferation period, fully formed at birth “(ISSVA classification).[1]. The hepatic hemangioma may present with vomiting and gastric outlet obstruction.[3] Hemangioma presenting as a gastric outlet and duodenal obstruction has been reported in the literature.[4,5] We decided to report this case because congenital hepatic hemangioma seldom presents with intestinal obstruction, and at times the resection of hepatic hemangioma becomes necessary in neonatal life. The baby underwent exploratory laparotomy with a diagnosis of congenital neonatal intestinal obstruction most likely small bowel atresia.

Results

Conclusion