Case A 25-year-old female was admitted to the emergency room with fatigue, recurrent black stools. She was hospitalized because of gastrointestinal hemorrhage. Profuse anemia with a hemoglobin level of 4.4 g/dl and the hematocrit 17% was detected. Three packs of red blod cell were transfused immediately. She did not have obvious hematochesia The upper gastrointestinal endoscopy did not show any bleeding lesion. An antral gastritis was only detected during the gastroduodenoscopy. Double contrast barium enema was also normal. We canceled the previously scheduled colonoscopic examination after detecting a 5 × 4 cm sized abdominal mass in the small bowel mesentery

through Inhibitor Library nmr abdominal computed tomography (Figure 1). Surgical exploration was planned. During the explorative laparotomy, a 5 × 5 cm sized mass was detected in the mesentery of the ileum. Partial small bowel resection and end-to-end small bowel anastomosis was performed. She was discharged on the 6th postoperative

day. Six months follow-up was uneventful. Figure 1 Oral and intravenous contrast enhanced computed tomography scan showing the mesenteric mass of the ileal small bowel segment (arrow). Histopathologic examination of the resected specimen revealed a cavernous hemagioma of mesenteric origin (Figures 2, 3). BIBW2992 molecular weight Figure 2 Mesenteric cavernous hemangioma with thin vascular wall and luminal cystic dilatation (1a-b, H&E, ×2, ×10). Figure 3 Immunohistochemical CD31 staining of endothelial cells

flooring dilated vessel (2, ×10). Discussion It is generally Mirabegron believed that hemangioma is a congenital hamartomatous lesion that originates from embryonic sequestrations of mesodermal tissue [1–5]. Hemangioma is a benign tumor, which can be seen in many organs. Approximately 200 cases of gastrointestinal hemangiomas have been reported since 1839 but only a few of these have been reported to involve the mesentery and part of the gut [1]. A classification system used by Abrahamson and Shandling divides intestinal hemangiomas into three categories on the basis of histologic appearances: capillary, cavernous, and mixed type [6]. The most common type is the cavernous hemangioma [6, 7]. Cavernous hemangiomas are macroscopically bluish purple, soft and compressible structures, arising from larger submucosal arteries and veins with varying lesion sizes. Gastrointestinal hemangiomas arise from the submucosal vascular plexuses and may invade the muscularis layer. There is rarely penetration beyond the serosa [10]. Gastrointestinal hemangiomas have been reported in patients ranging from 2 months to 79 years of age. No obvious sex predominance has been identified. They usually present in young men and women, often in the third decade of life [1–3]. The symptoms of hemangioma depends on the localization of the primary tumor.