貧血を契機に発見された終末回腸原発のpyogenic granulomaの1例

Pyogenic Granuloma of the Ileum Presenting with Anemia, Report of a Case

要旨●患者は50歳，女性．立ちくらみを主訴に前医を受診した．血液検査にて，Hb 9.0g/dlと貧血を認めたため，下部消化管内視鏡検査を施行した．回腸末端に8mm大の発赤調の隆起性病変を認め，精査加療目的で当院に紹介され受診となった．病理組織学的診断にてpyogenic granulomaと診断した．pyogenic granulomaの消化管発生は極めてまれであり，小腸原発の本邦報告は自験例を含め，13例である．大量下血例も報告されており，完全切除と経過観察が必要である．頻度は少ないが，消化管出血を来す原因として念頭に置くべき疾患である．

　A 50-year-old female was previously referred to a hospital for a chief complaint of dizziness. Blood tests revealed acute anemia（9.0g/dl）. Subsequently, she was referred to our hospital for further examinations. Colonoscopy revealed a sessile-shaped tumor（size, 8mm）in the ileum, for which endoscopic mucosal resection was performed. The pathological diagnosis was pyogenic granuloma. Pyogenic granuloma is rarely reported in the digestive tract ; till date, only 13 such cases with the granuloma originating from the ileum have been reported in Japan. Massive melena necessitates a complete resection and cautious follow-up owing to the likelihood of recurrence. This case highlights the identification of pyogenic granuloma as a cause of gastrointestinal bleeding.