Journal of the Formosan Medical Association
Volume 105, Issue 12 , Pages 1027-1030, 2006

Spontaneous Rupture of a Large Exogastric Hemangioma Complicated by Hemoperitoneum and Sepsis

  • Huan-Fa Hsieh

      Affiliations

    • Department of Surgery, Yee-Zen General Hospital, Taoyuan, Taiwan

Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

Received 22 August 2005; received in revised form 22 September 2005; accepted 7 February 2006.

Article Outline

Hemangiomas are benign congenital tumors of mature blood vessels and usually consist of dense masses of capillaries or larger blood vessels. Hemangioma of the stomach presenting with spontaneous rupture and sepsis is rare. We report a 22-year-old male who presented at the emergency room with sudden-onset epigastric pain, intractable nausea, and vomiting. Fever, tachycardia, leukocytosis and peritonitis were found on examination after admission. Computed tomography revealed a single, well-defined homogeneous lesion measuring approximately 6×8×9 cm in size over the left upper abdomen and hemoperitoneum. Laparotomy was performed because of intra-abdominal hemorrhage, peritonitis, and fever. During the operation, a dark red tumor was found on the greater curvature side of the stomach, accompanied by bleeding and hemoperi-toneum. The tumor was removed and a wedge resection of the stomach and partial omentectomy were performed. Histopathologic examination of the excised tumor revealed mixed cavernous-capillary hemangioma with central necrosis. The postoperative course was uncomplicated. The pathogenesis of spontaneous rupture and sepsis in this case may have resulted from pedicle torsion accompanied by ischemia, central necrosis, rupture of hemangioma and subsequent peritonitis and sepsis.

Key Words:  gastric hemangioma , hemangioma , hemoperitoneum , spontaneous rupture , stomach neoplasms

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PII: S0929-6646(09)60289-8

doi:10.1016/S0929-6646(09)60289-8

Journal of the Formosan Medical Association
Volume 105, Issue 12 , Pages 1027-1030, 2006

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