2022 Volume 58 Issue 5 Pages 788-792
The patient was a two-month-old girl who was followed up as an outpatient because hematochezia appeared approximately one month after birth. At two months of age, she was admitted to our department because of progressive anemia. A contrast enema showed a mass lesion of 8 mm diameter in the descending colon, which was considered to be the cause of bleeding. Colonoscopy revealed an easily bleeding tumor, and endoscopic mucosal resection (EMR) was performed under general anesthesia with surgical back up. However, a perforation was found at the resection site; thus, laparotomy was carried out. She underwent simple closure of the perforation of 2 cm diameter and drainage. The postoperative course was good, and no recurrence was observed. The histopathological results showed pyogenic granuloma, which is rare in the gastrointestinal tract except in the oral mucosa, and very few cases have been reported in children. Because of the hemorrhagic tendency, pyogenic granuloma should be kept in mind as a cause of gastrointestinal bleeding even in children. It is important to choose a safe and reliable treatment for each case. In this case, endoscopy was difficult because of the small size of the infant, and we should have switched to surgical resection before perforation occurred.
