Pyogenic granuloma of the small intestine

Abstract

This double balloon endoscopy image shows a pyogenic granuloma in the small intestine of a man in his 50s (fig 1). He presented with a two year history of melaena and passing shapeless, mucinous stools twice a day, and fatigue for five months. Blood tests showed iron deficiency anaemia (haemoglobin 70 g/L). No lesions were identified on gastroscopy and colonoscopy. Capsule endoscopy, however, indicated a bleeding jejunal mass in the small intestine, and double balloon endoscopy was performed to better locate the mass. The lesion was removed laparoscopically, with pathology confirming pyogenic granuloma. This common benignvasculartumouraffectstheskinormucousmembrane. 1 Althoughrarelyreportedinthegastrointestinal tract, pyogenic granuloma is a differential diagnosis for iron deficiency anaemia in the presence of bloody stools or melaena. 1 2