Gastric Hemangiomas in an Infant Managed with Argon Plasma Coagulation

Abstract

Hemangiomas that present in infancy do not typically affect the intestinal tract. We present a case of multiple hemangiomas limited to the gastric cavity in a 9-month-old infant. The case was complicated by thrombocytopenia. The medical management included intravenous corticosteroids, octreotide, and platelet infusions. Local injection of the gastric lesions with epinephrine, electrocoagulation with monopolar diathermy, and embolization of the left gastric artery did not significantly alter the transfusion requirement. Hemostasis and cessation of bleeding for 2 weeks were achieved with endoscopic argon plasma cautery. This was repeated at 12- to 14-day intervals on five occasions when new lesions appeared. Bleeding did not occur after interferon- α -2B was instituted, and no cause of the thrombocytopenia, which was still present 2 years later, was found. Overall, argon-based diathermy was effective for hemostasis and the ablation of gastric hemangiomas without significant complications.