A Case Report: Mesenteric Hemangioma of the Small Intestine with Melena

Yasunobu Funakoshi, Tokio Yamaguchi, Youji Seike, Nobukazu Nakashima, Noritsugu Ogawa, Toshihiro Kimura, Yasuhiko Yoshida, Masanobu Gotou and Taisei Yasuda^*

Department of Surgery and Pathology^*, Kawasaki Hospital

A 68-year-old woman was admitted with massive melena. There were no palpable abdominal masses, and her abdomen was not distended. Repeated gastrointentinal fiberscopy and total colonoscopy to the cecum yeilded normal findings. A barium meal study of the small intestine revealed only irregular external compression in the terminal ileum. Enhanced CT of the pelvis, however, showed a low density mass measuring 8 cm in diameter. Superior mesenteric arteriography showed stretching of the artery in the arterial phane, and pooling of the contrast medium at the end of the artery in the venous phase. In the pelvis, radionuclide scintigraphy with ^99mTc-HSA showed persistent increased uptake on delayed scans. We diagnosed the patient as having mesenteric tumor of the small intestine and performed partial resection of the small intestine. The tumor was approximately 8 cm in diameter and was located 80 cm proximal to the end of the ileum. Pathological examination showed the tumor to be a cavernous hemangioma. Mesenteric herangioma of the small intestine is extremely rare, with only 15 cases ever reported in Japan. Massive bleeding has never been reported as a main symptom. We have reported a woman with mesenteric hemangioma of the small intestine who presented with melena.

Key words
cavernous hemangioma, mesenteric tumor, melena

Reprint requests
Yasunobu Funakoshi Department of Surgery, Kawasaki Hospital 3-3-1 Higashiyama-cho, Hyougo-ku, Kobe, 652-0042 JAPAN

Accepted
November 30, 1999

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