Hemangioma Dr. Mark Pleatman shows a case of multiple incidental hepatic hemangiomas encountered during laparoscopic cholecystectomy. Hepatic hemangiomas are considered the most common nodules of the liver. It is seen more often in females, many times associated with focal nodular hyperplasia. Large lesion can be palpated and may lead to thrombocytopenia ( low platelets) due to platelet trapping. The chances of spontaneous rupture are minimal, therefore excision is not indicated. Large lesions may require anatomic resection specially when complications arise such as cardiac failure. Typical appearance of hemangioma. This one is on the anterior surface of the left lobe of the liver. Here is another pedunculated lesion just medial to the gallbladder. The lesions are very fragile and are prone to hemorrhage if injured, so care must be taken during retraction to avoid manipulating the lesions themselves. The gallbladder is now being dissected out of the liver bed; the surgeon begins to breathe easier. The procedure has been completed without disturbing the hemangiomas.