A Case of Duodenal Cavernous Hemangioma with Portal Thrombus

Daisuke Kakinuma, Yoshiharu Nakamura, Eiji Uchida, Takayuki Aimoto, Kazumitsu Cho, Gotaro Masuda*, Hiroyuki Onodera*, Hideaki Takasaki*, Hiroshi Yoshida and Takashi Tajiri

Department of Surgery, Nippon Medical School
Department of Surgery, Kamisu Saiseikai Hospital*

A 63-year-old woman admitted for upper abdominal epigastric pain reported rectal bleeding five days after admission. Subsequent abdominal computed tomography showed a retroperitoneal tumor 5 cm in diameter with an ill-defined margin adjacent to Treitz's ligament and a thrombus extending from the portal vein to the superior mesenteric vein, not recognized in scanning before she developed rectal bleeding. Upper gastrointestinal endoscopy and colonoscopy showed no abnormality. Double-balloon enteroscopy showed a reddish-brown granular tumor protruding into the lumen in the fourth portion of the duodenum, diagnosed by biopsy as cavernous hemangioma. The portal thrombus was observed because liver function parameters were consistently maintained within normal limits. Resection of the third and fourth portions of the duodenum and part of the jejunum was successful, and the thrombus had disappeared from scanning 3 months later without further intervention.

Key words
duodenal cavernous hemangioma, portal thrombosis

Reprint requests
Daisuke Kakinuma Department of Surgery, Nippon Medical School
1-1-5 Sendagi, Bunkyo-Ku, 113-8603 JAPAN

Accepted
May 31, 2007

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