A 78-year-old female with a bleeding elevated lesion in the sigmoid colon was referred to our hospital. Therefore, endoscopic mucosal resection (EMR) was performed. The pathological diagnosis was pyogenic granuloma. Despite the positive margin, further treatment was withheld because of the absence of hematochezia. After 3 months, she complained of hematochezia. Colonoscopy revealed an elevated lesion on the scar. We performed EMR using a ligation device. The pathological diagnosis was recurrence of pyogenic granuloma and positive margin. After 3 months, colonoscopy revealed a red area on the scar. Biopsy led to the pathological diagnosis of pyogenic granuloma. We performed follow up because the size was small and there was no bleeding. It is important to differentiate pyogenic granuloma from hematochezia, and an appropriate method is required for complete resection.
