title: Gastrointestinal bleeding in infantile hemangioma: a complication of segmental, rather than multifocal, infantile hemangiomas.
abstract: OBJECTIVE
  To highlight an association of facial segmental hemangiomas with gastrointestinal bleeding in infants with infantile hemangiomas.
  
  
  METHODS
  We conducted a multicenter retrospective case series study.
  
  
  RESULTS
  Ten female patients met study inclusion criteria; 8 were Caucasian, 9 had a facial segmental hemangioma, and 9 cases met the diagnostic criteria for definitive posterior fossa malformations, hemangioma, arterial lesions, cardiac anomalies/coarctation of the aorta and eye abnormalities syndrome with abnormalities of the aorta and cerebral arteriopathy. Severe gastrointestinal bleeding requiring blood transfusion occurred in 9 cases, with age at presentation of gastrointestinal bleeding ranging from 8 days to 6 months. When detected, the location of the hemangioma in the small intestine was in the distribution of the superior mesenteric artery. More than one agent was required to control the gastrointestinal bleeding, including oral or intravenous steroids, vincristine, oral propranolol, interferon, and resection of the small intestine. All cases needed ongoing support care with red blood cell transfusions.
  
  
  CONCLUSIONS
  Gastrointestinal bleeding is a rare complication of true infantile hemangioma. The segmental pattern of the cutaneous hemangioma associated with gastrointestinal bleeding should suggest a segmental infantile hemangioma of the lower gastrointestinal tract.
authors.affiliation: Department of Dermatology, Medical College of Wisconsin, Milwaukee, WI, USA. bdrolet@mcw.edu
authors.forename: Beth A
authors.initials: BA
authors.lastname: Drolet
authors.forename: Elena
authors.initials: E
authors.lastname: Pope
authors.forename: Anna M
authors.initials: AM
authors.lastname: Juern
authors.forename: Thomas
authors.initials: T
authors.lastname: Sato
authors.forename: Brandon
authors.initials: B
authors.lastname: Howell
authors.forename: Katherine Brown
authors.initials: KB
authors.lastname: Puttgen
authors.forename: Irene
authors.initials: I
authors.lastname: Lara-Corrales
authors.forename: Amy
authors.initials: A
authors.lastname: Gilliam
authors.forename: Anthony
authors.initials: A
authors.lastname: Mancini
authors.forename: Julie
authors.initials: J
authors.lastname: Powell
authors.forename: Dawn
authors.initials: D
authors.lastname: Siegel
authors.forename: Denise
authors.initials: D
authors.lastname: Metry
authors.forename: David A
authors.initials: DA
authors.lastname: Stevenson
authors.forename: Johannes F
authors.initials: JF
authors.lastname: Grimmer
authors.forename: Ilona J
authors.initials: IJ
authors.lastname: Frieden
mesh_terms: D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D006391:Hemangioma / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007231:Infant, Newborn