PMC4163179_01
Multiple hemangiomas on extremities
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F0001
Physical examination revealed dark bluish, compressible and refillable, multiple papules with definite boundary on trunk and extremities (Figure 1), as well as fixed tenderness in lower abdomen without guardness.
Typical sign of intestinal intussusception in abdominal CT scan: concentric circle (white arrow)
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F0002
Abdominal computed tomography on admission demonstrated the presence of intestinal intussusception according to the typical sign of concentric circle (Figure 2), thus an exploratory laparotomy was determined.
Gastric angeioma discovered via intraoperative gastroduodenoscopy
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F0003
During the course of tentative manual reduction, two serosal hemangiomas on the incarcerated intestinal was detected (Figure 3), which necessitated the following removal of incarcerated intestine.
Blue rubber blebs in excised small intestine
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F0004
To exclude the potential gastrointestinal venous malformation anywhere else, intraoperative esophagogastroduodenoscopy was performed and then a wedge gastrectomy was carried out because of a isolated angioeoplasm found in gastric lumen (Figure 4).
Microscopically, the dilated blood vessel was alternately covered with collagenous fibers (blue arrow) and a single layer of endothelial cells (H&E x200)
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F0005
The postoperative course was uneventful and pathological examination revealed multiple cavernous hemangiomas in the resected gastrointestines and eventually the patient recovered uneventfully (Figure 5).