A CASE OF PYOGENIC GRANULOMA OF THE JEJUNUM FOUND IN A PATIENT WITH ANEMIA

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  • ISOBE Taro
    Department of Surgery, Kurume University School of Medicine, Department of Surgery, Sasebo Kyousai Hospital
  • MATSUMOTO Atsushi
    Department of Surgery, Kurume University School of Medicine, Department of Surgery, Sasebo Kyousai Hospital
  • AOYAGI Shigeaki
    Department of Surgery, Kurume University School of Medicine, Department of Surgery, Sasebo Kyousai Hospital
  • SHIROUZU Kazuo
    Department of Surgery, Kurume University School of Medicine, Department of Surgery, Sasebo Kyousai Hospital

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  • 貧血を契機に発見された空腸ｐｙｏｇｅｎｉｃ　ｇｒａｎｕｌｏｍａの１例

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Abstract

The patient was a 79-year-old female with complaints of exertional palpitation and chest pain. Upper gastrointestinal endoscopic study, blood pool scintigraphy and CT study did not reveal any abnormal findings. Endoscopic study of the small intestine revealed a mobile, easily bleeding pedunculated protruding tumor of about 20mm in size in the jejunum at about 270cm from the mouth. Cytology study of the tumor revealed granulating tissue and inflammatory cells. Segmental resection of the jejunum was performed for diagnosis and treatment. Pathohistological study revealed superficial erosions, proliferation of vessels of different sizes in the edematous interstitial space and partial leaflet like proliferations were observed. Accordingly the diagnosis of pyogenic granuloma was made. Pyogenic granuloma which arises in the intestinal tract other than in oral mucosa is extremely rare and only 29 cases are reported in Japan until now. The ones that arose in the jejunum are only 3 cases including ours. Massive melena and recurrences are reported and so a complete resection and careful follow-up are important. In case of intestinal bleeding of unknown origin, the possibility of this pathology should be included in the differential diagnosis.

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