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case_images: (A) Abdominal color ultrasonography shows stiff morphology of small intestine with slightly obstructed passage of contents, suggesting segmental venous malformation. (B) Abundant blood flow signals are seen around the wall of the small intestine. Enhanced abdominal CT shows focal thickening of the small intestine wall with tortuous, chaotic and high-density vascular shadows. The blood supply artery is from the superior mesenteric artery. This indicated venous malformation of the small intestine (C) with coronary vascular signs and (D) with cross-sectional vascular signs.
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case_images: These findings were suggestive of a left upper jejunal segmental venous malformation (cavernous hemangioma) of the umbilical cord ( Figures 1A, B ). The preliminary diagnosis was a local intestinal wall thickening in the left jejunum of the upper abdomen with multiple tortuous vascular shadows, suggestive of an intestinal venous malformation ( Figures 1C, D ).
case_images: (A) Location of Trocar in the umbilical cord (B) Microscopic view of small intestinal hemangioma (C) Gross view of the resected small intestinal hemangioma marked tortuous dark red vessels with obvious congestion in the serous membrane. (D) postoperative appearance of the umbilical cord.
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case_images: Laparoscopic light source was placed in the right Trocar for observation, and laparoscopic intestinal forceps were placed in the left Trocar ( Figure 2A ). Treitz's ligament ( Figure 2B ). The lesion was mainly located at the mesangial margin. The mesenteric vessels were ligated and sutured ( Figure 2C ). 8)The diseased segment of the small intestine was completely removed, and an end-to-end intestinal anastomosis was performed using discontinuous sutures with a 5-0 absorbable suture. 9)The anastomosis was carefully checked for patency and absence of leakage. The mesenteric hematoma was repaired. 10)The small intestine was returned to the abdomen. No bleeding was observed, and the umbilical incision was closed layer by layer ( Figure 2D ).
case_images: (A) Under electron microscope, the submucosa showed irregular dilated vessels with multiple lumens. The vascular wall was lined with small and deeply stained endothelial cells, and the vascular endothelial hyperplasia was obvious (Hematoxylin and eosin staining,x100). (B) Immunohistochemical staining results showed that cells arranged in the vascular space were CD31 positive. (Immunohistochemical staining, x100).
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case_images: No hemangioma components were identified at the incisal margins on both sides of the intestinal duct ( Figure 3A ). Immunohistochemical staining showed positive expression of the vascular endothelial biomarker CD31 ( Figure 3B ).
case_images: Complete timeline, including diagnosis (surgery) and treatment.
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case_images: Blood cell analysis indicated a red blood cell count of 4.77x1012/L and a hemoglobin level of 129g/L ( Figure 4 ).