Successful treatment of visceral infantile hemangioma of the omentum and mesentery with propranolol

Abstract

Infantile hemangiomas (IH) are the most common tumors of infancy. In the typical cutaneous presen- tation, they follow a predictable and benign clinical course requiring medical intervention only for growth that interferes with vision or respiration, or, rarely, in cases of intractable bleeding. Hemangi- omas arising from within visceral structures or surfaces are far less common, but can be associated with increased morbidity and mortality secondary to gastrointestinal hemorrhage, abdominal compartment syndrome, high output cardiac failure, and hypothyroidism. Here we present the case of a three-week- old boy with acute abdomen caused by hemorrhage of a hemangioma of the omentum and mesentery. He underwent operative exploration with debulking of the lesion and was subsequently treated with propranolol. Serial imaging demonstrated gradual involution and he remained free of further life- threatening events.