Intestinal hemangiomas are rare, they account for 0.3% of all gastrointestinal tumors and about 3-4% of all benign tumors of the small intestine.
What it is?
Hemangioma is a benign tumor-like growth consisting of vascular tissue. There are polypoid hemangiomas of the small and large intestines, multiple phlebexstasias, cavernous hemangiomas and generalized hemangiomatosis. The shape and size of hemangiomas are very diverse.
Symptoms
Polypoid hemangiomas of the small and large intestines can lead to obstruction, intussusception, intestinal bleeding and chronic anemia. About 30% of all angiomatous lesions are asymptomatic.
With multiple phlebexstasias, we are talking about numerous “tumors” of a bluish color, ranging in size from 0.1 to 0.5 cm. They are most often located in the mucous membrane and submucosa and make up 40-60% of all intense hemangiomatous lesions.
Osler telangiectasia is a disease described by the English physician Osler, characterized by the presence of multiple hereditary telangiectasia of the skin and mucous membranes. Telangiectasias are localized mainly on the lips and nasal mucosa, as well as the wall of the small and large intestines. Symptoms depend on the position of the angioma and are expressed by nasal and intestinal bleeding.
With cavernous hemangiomas, one should distinguish between diffuse-infiltrative and polypoid forms. The surface of cavernous hemangioma is colored bluish and has a soft-elastic consistency.
The polypous form, as a rule, is represented by a tumor.
The clinical picture of cavernous hemangioma of the small intestine is characterized by
- bleeding,
- intestinal obstruction,
- repeated invaginations.
Diffuse-infiltrative cavernous hemangiomas are localized mainly in the mucous membrane and gradually spread to all layers of the intestine. Cavernous hemangiomas are found equally often in the jejunum and ileum, less often in the duodenum. As the tumor grows, clinical symptoms may appear, first of all, bleeding, then symptoms of obstruction.
In generalized hemangiomatosis, we are talking about cavernous or capillary hemangiomatous lesions. Their frequency ranges from 2 to 12% of all hemangiomas. This type of hemangiomas is characterized by severe internal bleeding.
Diagnostics
Endoscopic methods occupy the main place in making a diagnosis. When hemangiomas are localized in the small intestine, the diagnosis can be very difficult to establish. Used to search for tumors
- selective angiography of the main branches of the abdominal aorta,
- total enteroscopy,
- radionuclide methods for diagnosing bleeding.
Differential diagnosis is made with other intestinal tumors, diverticula , complicated by recurrent bleeding.
Treatment
Treatment is mainly surgical. For small phlebectasias of the intestinal mucosa, endoscopic electrocoagulation of the tumor can be used.
The prognosis is favorable.
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