小肠血管瘤致反复消化道出血3例报告及文献复习

目的总结小儿小肠血管瘤的临床特点及诊治情况。方法对1994~2004年我院收治3例及国内报道44例小肠血管瘤的发病部位、病理、临床表现、诊断及治疗进行分析。结果空肠段血管瘤占31.9%,回肠段42.6%,十二指肠段4.2%,多部位21.3%。单发29.8%,多发70.2%。10例病理结果示20%为毛细血管瘤,60%为海绵状血管瘤,混合型血管瘤及淋巴血管混合瘤各占10%。39例表现为反复黑便,5例呈肠套叠,1例因大量便血而致休克。出现肠梗阻5例。血红蛋白<90g/L38例。术前确诊率仅为10.6%。47例均采取手术治疗。结论小肠血管瘤好发于回肠及空肠,且以多发性常见。本病以无痛性反复便血为主要特点。术前诊断困难,手术切除病灶为最佳治疗方法。

Hemangioma of Small Intestine in Children Causing Recurrent Gastrointestinal Hemorrhage:3 Cases Report and Literature Review

Objective To summarize the clinical characteristics and diagnosis and treatment of hemangioma of small intestine in children.Methods Location,pathology,clinical manifestation,diagnosis and treatment of 3 cases from our hospital and 44 cases reported in our courtry with hemangioma of the small bowel were analyzed from 1994 to 2004.Results These tumors locating in jejunum,ileum,duodenum as well as parts small intestine were 31.9%,42.6%,4.2% and 21.3%,respectively.Solitary and multiple tumors were 29.8% and 70.2% separately.The histopatholical report of 10 cases revealed that capillary,cavernous,mixed type hemangioma and hematolymphangioma were 2,6,1 and 1 cases,respectively.Thirty nine children presented with recurrent black stool.Five patients manifest in the form of intussusception.One child passed a bloody stool so massive as to cause shock.Small-bowel obstruction occurred in 5 cases.The hemoglobin of 38 patients were lower than 90 g/L.The incidence of preoperative diagnosis was only 10.6%.All of patients were performed operation.Conclusions The frequent locations of hemangioma of small intestine are in ileum and jejunum,and multiple tumors are common.The diseases are characterized as recurrent hematochezia with painlessness.Preoperative diagnosis of a small bowel hemangioma can be very difficult.The segments of small bowel with hemangioma resection are the most method of the treatment.