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KMID : 0614620160670040220
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Korean Journal of Gastroenterology
2016 Volume.67 No. 4 p.220 ~ p.223
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Hepatic Hemangioma with Kasabach-Merritt Syndrome in an Adult Patient
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Oak Chan-Young
Jun Chung-Hwan
Cho Eun-Ae
Lee Du-Hyeon
Cho Sung-Bum
Park Chang-Hwan
Joo Young-Eun
Kim Hyun-Soo
Rew Jong-Sun
Choi Sung-Kyu
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Abstract
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Hemangiomas are the most common benign tumors of the liver. They are generally asymptomatic, but giant hemangiomas can lead to abdominal discomfort, bleeding, or obstructive symptoms. Kasabach-Merritt syndrome is a rare but life-threatening complication of hemangioma, characterized by consumptive coagulopathy with large vascular tumors. More than 80% of Kasabach-Merritt syndrome cases occur within the first year of life. However, there are few reports of Kasabach-Merritt syndrome with giant hepatic hemangioma in adults and, as far as we know, no reports of Kasabach-Merritt syndrome with hepatic hemangioma treated with first line medical treatment only. The most important treatment for this syndrome is removal of the large vascular tumor. However, surgical treatment entails risk of bleeding, and the patient’s condition can mitigate against surgery. We herein present a case of unresectable giant hepatic hemangioma with disseminated intravascular coagulopathy. The patient was a 60-year-old woman who complained of hematochezia, ecchymosis, and abdominal distension. She refused all surgical management and was therefore treated with systemic glucocorticoids and beta-blockers. After two weeks of steroid therapy, she responded partially to the treatment. Her laboratory findings and hematochezia improved. She was discharged on hospital day 33 and observed without signs of bleeding for three months.
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KEYWORD
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Kasabach-Merritt syndrome, Hemangioma, Disseminated intravascular coagulation
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