Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Feb 15;59(4):501-505.
doi: 10.2169/internalmedicine.3745-19. Epub 2019 Oct 15.

Clinical and Endoscopic Characteristics of Pyogenic Granuloma in the Small Intestine: A Case Series With Literature Review

Free PMC article

Clinical and Endoscopic Characteristics of Pyogenic Granuloma in the Small Intestine: A Case Series With Literature Review

Yukie Hayashi et al. Intern Med. .
Free PMC article


Pyogenic granuloma (PG) generally appears in the skin or oral cavity, but rarely occurs in the small intestine, where it can cause bleeding. To date, only 35 cases of small intestinal PG have been reported in the English literature. We retrospectively collected information from the clinical records of seven cases of small intestinal PG that were managed in our hospital and summarized the characteristics. Further information on the clinical characteristics was obtained from the literature. Capsule endoscopy, useful for identifying the source of hemorrhage in obscure gastrointestinal bleeding, can detect PGs. Treatment can often be accomplished with endoscopic mucosal resection.

Keywords: capsule endoscopy; obscure gastrointestinal bleeding; pyogenic granuloma.

Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).


Figure 1.
Figure 1.
Endoscopic and ultrasonic images of a pyogenic granuloma (Patient 2). The endoscopic findings from Patient 2. (a) Capsule endoscopy detected bleeding from a 5-mm semi-pedunculated polyp in the ileum. (b) The lesion was also seen on single-balloon enteroscopy. (c) On endoscopic ultrasonography (EUS), the muscle layer and tumor could not be clearly distinguished.
Figure 2.
Figure 2.
Hematoxylin and Eosin (H&E) (a) and anti-CD34 staining (b) of a pyogenic granuloma (Patient 2). The pathology findings from Patient 2 (Low magnification: ×12, High magnification: ×240). (a) H&E staining showed increased, lobulated, and enlarged capillaries and desquamated epithelium, indicating epithelial erosion. (b) Immunostaining with CD34, a marker of vascular endothelial cells, showed capillary proliferation.

Similar articles

See all similar articles


    1. Poncet A, Dor L. Botruomycose humaine. Rev Chir 18: 996, 1897.
    1. Hartzell MB. Granuloma pyogenicum. J Cutan Dis 22: 520-523, 1904.
    1. Moffatt DC, Warwryko P, Singh H. Pyogenic granuloma: an unusual cause of massive gastrointestinal bleeding from the small bowel. Can J Gastroenterol 23: 261-264, 2009. - PMC - PubMed
    1. Lewis BS. Small intestinal bleeding. Gastroenterol Clin North Am 29: 67-95, vi, 2000. - PubMed
    1. Motohashi Y, Hisamatsu T, Ikezawa T, et al. [A case of pyogenic granuloma in the small intestine]. Nihon Shokakibyo Gakkai Zasshi 96: 1396-1400, 1999. - PubMed