Jejunal hemangioma

　　The etiology of jejunal hemangioma is not yet clear. Hemangiomas generally originate from blood vessels or lymphatic vessels under the mucosa, or from subserosal blood vessels. About 90% of jejunal hemangiomas occur in the jejunum and ileum, with the jejunum being the most common, accounting for about 48.2%, followed by the ileum (41.6%). Duodenal hemangiomas account for only 8% to 10%.

　　The complications of jejunal hemangioma mainly include the following:

　　1, Anemia

　　Long-term intermittent bleeding from hemangiomas can lead to anemia in patients, which is often misdiagnosed as iron deficiency anemia in clinical practice.

　　2, Intestinal obstruction

　　Cavernous hemangiomas can encircle the small intestine, causing intestinal obstruction. Patients may present with symptoms and signs of incomplete or complete mechanical intestinal obstruction.

　　3, Intussusception

　　Jejunal hemangioma is rarely complicated with intussusception.

　　The clinical manifestations of jejunal hemangioma mainly include the following:

　　1, Gastrointestinal bleeding

　　Gastrointestinal bleeding is the main manifestation of jejunal hemangioma and one of the main reasons for patients to seek medical attention. About 1/3 to 1/2 of hemangioma patients may have gastrointestinal bleeding. The mucosa on the surface of the hemangioma often forms ulcers, leading to chronic bleeding. The amount of bleeding in patients is usually small and can present as intermittent black stools, tarry stools, or only positive occult blood test in stool.

　　2, Abdominal pain

　　Some patients may present with abdominal pain as the first symptom, which is usually a hidden, dull pain in the middle abdomen, without obvious regularity.

　　3, Intestinal obstruction and intussusception

　　Jejunal hemangioma is rarely complicated with intestinal obstruction and intussusception. Intestinal obstruction is often caused by intussusception, which can often resolve spontaneously, showing intermittent symptoms, and a mass palpable in the abdomen during an attack.

　　4, Decreased appetite

　　Some patients may experience decreased appetite, weight loss due to long-term chronic anemia, obstruction, and abdominal pain.

　　Gastrointestinal bleeding is the main manifestation of jejunal hemangioma and one of the main reasons for patients to seek medical attention. There is currently no preventive method for jejunal hemangioma, and only low-fiber foods can be eaten to reduce the chance of bleeding.

　　The auxiliary examinations for small intestinal hemangioma mainly include the following types:

　　First, laboratory examination

　　1. Blood routine examination

　　Long-term chronic hemorrhage can lead to small cell hypochromic anemia.

　　2. Stool examination

　　Fecal occult blood test can be positive.

　　Second, other auxiliary examinations

　　1. Selective mesenteric angiography

　　Selective mesenteric angiography during the bleeding period is the best diagnostic method for localization and定性.

　　2. Fiberoptic endoscopic examination

　　Under the microscope, small polypoid masses protruding into the intestinal lumen can be seen, which are red or purple, localized or disseminated, or only dark red or purple spots.

　　3. X-ray examination

　　X-ray has certain value for localized polypoid hemangioma. Occasionally, abdominal X-ray examination can reveal multiple movable calcified points, indicating that the thrombus in the blood vessels has calcified.

　　In terms of diet, the following points should be noted for patients with small intestinal hemangioma:

　　1. Intestinal hemangioma patients should avoid smoking and drinking, overeating, and eating spicy and刺激性 foods such as scallions, garlic, Sichuan pepper, chili, and cassia.

　　2. Avoid salted, smoked, roasted, and fried foods, especially charred and carbonized foods.

　　3. Avoid moldy, pickled and vinegar foods, such as moldy peanuts, moldy soybeans, salted fish, pickled vegetables, etc.

　　4. Avoid eating foods with many bones, rough and hard foods, sticky and difficult to digest foods, and foods containing coarse fibers.

　　Surgical treatment can be performed for cases of symptomatic small intestinal hemangioma. Surgical resection is the main treatment method for this disease. The purpose of most operations is to stop bleeding. The following two points should be noted during treatment:

　　1. Determining the Bleeding Site

　　Due to the soft nature of the tumor, small tumors are difficult to touch with hands during surgery, making it difficult to locate. Intestinal tube transillumination combined with palpation can be used, which is easier to display the lesion after the intestinal tube is inflated. Endoscopic examination during surgery can improve the detection rate of the lesion. By injecting labeled 99mTc red blood cells, the intestinal tubes can be clamped separately, and the radioactivity of each segment of the intestinal tube can be measured to determine the bleeding site.

　　2. Surgical Resection Range

　　Surgical resection of the intestinal segment with lesions, the extent of resection is the same as that of local resection of benign small intestine. During the operation, attention should be paid to a detailed exploration of the lesion to avoid missing it. If there is no other hidden bleeding site, it can generally be cured.