Abstract
The patient was a 40-year-old man who had visited his previous doctor with the complaints of black stools and dizziness. Blood tests showed severe anemia, and upper gastrointestinal bleeding was suspected. He had undergone contrast CT and had been diagnosed with small bowel bleeding ; he was then referred to our hospital. When admitted to our hospital, CT was performed again and revealed no extravasation, but an enhanced mass of 7.5 mm, which was considered the source of bleeding, was seen. Urgent enteroscopy was performed, and a semi-pedunculated tumor of 10 mm was observed in the ileum. Neither bleeding from the tumor nor progression of anemia was observed, so elective single-incision laparoscopic surgery with partial resection of the small intestine was performed after confirming that there was no other bleeding source. On pathological examination, the diagnosis was pyogenic granuloma. Pyogenic granuloma occurs rarely in the digestive tract, and there are only 12 reported cases that originated from the ileum in Japan. However, because severe anemia often occurs, this disease should be noted as a cause of gastrointestinal bleeding, and an algorithm from its diagnosis by dynamic CT and enteroscopy to treatment such as laparoscopic surgery is useful.
