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Recurrent bloody stools associated with visceral infantile haemangioma in a preterm twin girl
  1. Jeanne Krick1,
  2. Kimberly Riehle2,
  3. Teresa Chapman3 and
  4. Shilpi Chabra1
  1. 1 Neonatology, University of Washington, Seattle, Washington, USA
  2. 2 Pediatric General and Thoracic Surgery, Seattle Children’s Hospital, Seattle, Washington, USA
  3. 3 Radiology, University of Washington, Seattle, Washington, USA
  1. Correspondence to Dr Shilpi Chabra, schabra{at}


A premature twin infant girl was transferred to a level IV neonatal intensive care unit for recurrent bloody stools, anaemia and discomfort with feeds; without radiographic evidence of necrotising enterocolitis. Additional imaging after transfer revealed a large retroperitoneal mass in the region of the pancreas compressing the inferior vena cava and abdominal aorta, raising suspicion for neuroblastoma. Abdominal exploration and biopsy unexpectedly revealed that the lesion was an infantile capillary haemangioma involving the small bowel, omentum, mesentery and pancreas. The infant was subsequently treated with propranolol, with a decrease in the size of the lesion over the first year of her life and a drastic improvement in feeding tolerance. While cutaneous infantile haemangiomas are common, visceral infantile haemangiomas are less so and may present a significant diagnostic challenge for clinicians. This interesting case demonstrates that such lesions should be considered in the differential diagnosis for unexplained gastrointestinal bleeding or abdominal symptoms in newborns.

  • neonatal intensive care
  • paediatric surgery

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  • Contributors JK created the initial draft of the manuscript. KR, TC and SC all provided edits to the manuscript. All authors were involved in the initial conception of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.