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Individualized Management in 22 Cases

Thomas R. Weber, MD; Robert H. Connors, MD; Thomas F. Tracy, Jr, MD; Patrick V. Bailey, MD

Arch Surg. 1990;125(8):1017-1021.

Abstract
• Large hemangiomas in infants and children are rare but can be life-threatening if they involve vital structures or produce thrombocytopenia or congestive heart failure. During a 6-year period, 22 infants and children, aged newborn to 7 years, were treated for complex, symptomatic hemangiomas. The lesions were located in the liver in seven, face or parotid gland in five, neck in four, extremity in two, and mediastinum, chest wall—spinal cord, trachea, and retroperitoneum in one patient each. The diagnosis was suggested by physical examination in all patients and was confirmed by radiologic examination in most patients. The treatment was individualized, usually progressed from less to more invasive, and included observation, prednisone therapy, arterial ligation, and resection. All children were eventually cured, with minimal morbidity. Children with life-threatening hemangiomas can be successfully managed with the use of a variety of techniques.

(Arch Surg. 1990;125:1017-1021)

Author Affiliations
From the Division of Pediatric Surgery, Department of Surgery, St Louis (Mo) University School of Medicine and Cardinal Glennon Children's Hospital.

Footnotes
Accepted for publication May 11, 1990.

Read before the 97th Annual Meeting of the Western Surgical Association, St Louis, Mo, November 14, 1989.

Reprint requests to the Department of Pediatric Surgery, Cardinal Glennon Children's Hospital, 1465 S Grand Blvd, St Louis, MO 63104 (Dr Weber).

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