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Embolization of hepatic hemangiomas in infants
C-M Kullendorff1, W Cwikiel, S Sandström
1Department of Pediatrics, University Hospital Lund, Sweden. carl-magnus.kullendorff@skane.se
Insights
Intra-arterial embolization effectively treated two newborns with symptomatic giant liver hemangiomas. This minimally invasive procedure reduced critical symptoms like rapid breathing and heart enlargement in infants.
Area of Science:
- Pediatric Surgery
- Interventional Radiology
- Hepatology
Background:
- Cavernous liver hemangiomas are rare benign liver tumors.
- Infantile hemangiomas can cause significant cardiorespiratory distress.
- Early diagnosis and intervention are crucial for symptomatic cases.
Observation:
- Two newborns presented with symptomatic giant liver hemangiomas shortly after birth.
- Symptoms included tachypnea and cardiac dilation, indicative of significant shunting.
- Diagnostic imaging (ultrasound, CT) confirmed large hemangiomas in different liver lobes.
Findings:
- Superselective intra-arterial embolization was performed using Lipiodol and Histoacryl.
- Post-embolization, a reduction in tachypnea and cardiac volume was observed.
- One infant required subsequent surgery for gastrointestinal bleeding.
Implications:
- Intra-arterial embolization is a viable treatment for symptomatic neonatal liver hemangiomas.
- This interventional technique can stabilize critically ill infants.
- Further research may explore long-term outcomes and optimal embolic agents.
Abstract:
A small number of cavernous liver hemangiomas in infants cause serious symptoms, requiring active treatment. We report two newborns with giant liver hemangiomas, treated by intra-arterial embolization. The babies presented at 2 - 8 days after birth with tachypnoea and cardiac dilation. A giant liver hemangioma located in the right liver lobe in one infant and in the left liver lobe in the other was found at ultrasonography and computed tomography. Dilated liver veins indicated abnormal shunting of the blood through the hemangiomas. Because of progress of symptoms superselective embolization of the arteries feeding the hemangiomas and arising from the celiac trunk was performed with a mixture of Lipoidol and Histoacryl. A decrease of tachypnoea and of heart volume was noted after embolization. In one infant surgery was necessary due to gastrointestinal bleeding. The intra-arterial embolization is a valuable method for the treatment of newborns with symptomatic cavernous liver hemangiomas.
