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Review
. 2009 Apr;23(4):261-4.
doi: 10.1155/2009/579163.

Pyogenic granuloma: an unusual cause of massive gastrointestinal bleeding from the small bowel

Dana C Moffatt  1 , Paul Warwryko, Harminder Singh
Affiliations
Review

Pyogenic granuloma: an unusual cause of massive gastrointestinal bleeding from the small bowel

Dana C Moffatt et al. Can J Gastroenterol. 2009 Apr.

Abstract
in English, French

Small bowel hemorrhage is responsible for approximately 4% of all cases of gastrointestinal bleeding. The etiology of bleeding from the small bowel is a tumour in approximately 10% of cases. Pyogenic granuloma is a common inflammatory vascular tumour of the dermis, which rarely occurs in the gastrointestinal tract. Pyogenic granuloma is a rare cause of overt or obscure small bowel bleeding. The present paper reports the first case of pyogenic granuloma presenting as a massive gastrointestinal bleed, and reviews the relevant literature to date regarding the clinical presentation, diagnosis and management of this rare gastrointestinal lesion.

L’hémorragie de l’intestin grêle est responsable d’environ 4 % de tous les cas d’hémorragies gastro-intestinales. Dans environ 10 % des cas, l’étiologie du saignement de l’intestin grêle est une tumeur. Le granulome pyogène est une tumeur inflammatoire et vasculaire courante du derme, qu’on observe rarement dans le tube digestif. C’est une cause rare d’hémorragie manifeste ou occulte de l’intestin grêle. Le présent article présente le premier cas de granulome pyogène se manifestant sous forme d’hémorragie gastro-intestinale massive et passe en revue les publications pertinentes au sujet de la présentation clinique, du diagnostic et de la prise en charge de cette rare lésion gastro-intestinale.

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Figures

Figure 1)
Figure 1)
Jejunal pyogenic granuloma seen on push enteroscopy. The arrow indicates the distinctive white film coating
Figure 2)
Figure 2)
Microscopy image of postsurgery pyogenic granuloma tissue showing dense vascular proliferation and inflammatory reaction in the stroma, consistent with pyogenic granulomas (hematoxylin and eosin stain, original magnification ×40)
Figure 3)
Figure 3)
Immunohistochemical study in the same case shows negative staining for human herpes virus-8 (immunoperoxidase stain, original magnification ×40)
Figure 4)
Figure 4)
Immunohistochemical staining for CD34 shows the endothelial cell population (immunoperoxidase stain, original magnification ×10). CD31 and factor VIII stains were also used to identify endothelial cells (data not shown)
See this image and copyright information in PMC

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