Clinical approach, imaging and treatment of congenital hepatic hemangioma

Abstract

Congenital hemangiomas are benign endothelial tumors which usually have a benign course. In some rare cases they can reach large dimensions and cause platelet sequestration and consumption of coagulation factors resulting
in life threatening coagulopathy and heart failure. This syndrome is known as Kasabach-Merritt. Case: This report pertains the case of a newborn female patient with a giant congenital hepatic hemangioma who developed signs and
symptoms of heart failure, pulmonary congestion, and coagulopathy. Discussion: The combination of corticosteroids and propranolol was successfully used in this case to reduce the size and hemodynamic repercussions of this lesion.
Likewise, invasive mechanical ventilation with PEEP (positive end expiratory pressure) above 4 cmH20 was used in order to maintain hemodynamic stability in addition to ensuring adequate ventilation. Conclusions: This condition is very rare ant therefore there are no published homogeneous guidelines for its management. This case report aims to document our experience to contribute to the complex management of this entity.