Format

Send to

Choose Destination
J Pediatr Surg. 2017 Apr;52(4):598-601. doi: 10.1016/j.jpedsurg.2016.08.019. Epub 2016 Sep 1.

Management of pediatric intramuscular venous malformations.

Author information

1
Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: meensey@gmail.com.
2
Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: nowicki@chla.usc.edu.
3
Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: kschall@chla.usc.edu.
4
Department of Radiology, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: czeinati@chla.usc.edu.
5
Department of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: lhowell@chla.usc.edu.
6
Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: danselmo@chla.usc.edu.

Abstract

BACKGROUND:

Intramuscular venous malformations (VMs) are rare, but can be highly symptomatic. There are few reports on outcomes, particularly pain, functional limitations, and muscle contractures. We aimed to compare results of medical management, sclerotherapy, and surgical resection.

METHODS:

We retrospectively reviewed 45 patients with an extremity or truncal intramuscular VM between June 2005 and June 2015 at a single institution. Outcomes were compared between treatment modalities with ANOVA and χ2 tests.

RESULTS:

Six patients (13%) were treated with medical management, 4 (9%) with surgical resection, 23 (51%) with sclerotherapy, and 12 (27%) with both surgery and sclerotherapy. Sclerotherapy alone decreased pain in 72%. Only 20% of patients presented with muscle contracture. For these patients, 33% resolved with sclerotherapy, physical therapy, and aspirin; 22% resolved with surgery, and 45% had persistent contracture. 40% of patients treated with sclerotherapy then surgery developed new muscle contractures, compared to 4% of sclerotherapy only patients and 0% of surgery only patients (p=0.04).

CONCLUSIONS:

Medical management, surgery and sclerotherapy are effective treatments for intramuscular VMs. Observation and supportive care can be a primary treatment for patients with minimal symptomatology and no functional limitations. Sclerotherapy is more effective for treating pain than contractures and when used alone, rarely causes a new muscle contracture.

KEYWORDS:

Muscle contracture; Sclerotherapy; Vascular anomaly

PMID:
27622586
DOI:
10.1016/j.jpedsurg.2016.08.019
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center