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Nomura K, Shibuya T, Yuzawa A, Omori M, Odakura R, Koma M, Ito K, Kamba E, Maruyama T, Nomura O, Fukushima H, Murakami T, Ueda K, Ishikawa D, Hojo M, Nagahara A. Residual Recurrence of a Small Intestinal Capillary Hemangioma with Obscure Gastrointestinal Bleeding Treated by Double-Balloon Endoscopy: A Case Report and Literature Review. J Clin Med 2024; 13:3415. [PMID: 38929942 PMCID: PMC11204303 DOI: 10.3390/jcm13123415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/03/2024] [Accepted: 06/08/2024] [Indexed: 06/28/2024] Open
Abstract
An 86-year-old man presented with anemia. He underwent abdominal contrast-enhanced computed tomography, gastroscopy, and colonoscopy without any bleeding detected. Small bowel capsule endoscopy (SBCE) revealed a reddish polypoid lesion with blood oozing into the jejunum. Antegrade double-balloon endoscopy (DBE) revealed a 5 mm sized protrusion into the jejunum. Endoscopic mucosal resection (EMR) was difficult; the lesion was snared and resected before energization. Clips prevented further bleeding and the lesion's position was marked with a tattoo. Histopathological examination of the lesion led to a diagnosis of capillary hemangioma. After 11 months, the patient was again anemic. A reddish polypoid lesion oozing blood near the tattoo was found by SBCE. Another antegrade DBE showed a 7 mm sized protrusion near the tattoo. The lesion was successfully treated by EMR. Histopathological examination revealed the residual recurrence of a small intestinal capillary hemangioma. The patient recovered from anemia after the EMR. Two months later, SBCE showed no findings around the tattoo. Hemangiomas account for 7-10% of benign small intestinal tumors; most are cavernous hemangiomas, and capillary hemangiomas are rare. We report a rare case of a recurring small intestinal capillary hemangioma detected by SBCE and treated using DBE. We also review the literature.
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Affiliation(s)
| | - Tomoyoshi Shibuya
- Department of Gastroenterology, School of Medicine, Juntendo University, Bunkyo-ku, Tokyo 113-8421, Japan; (K.N.); (A.Y.); (M.O.); (R.O.); (M.K.); (K.I.); (E.K.); (T.M.); (O.N.); (H.F.); (T.M.); (K.U.); (D.I.); (M.H.); (A.N.)
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Ikeoka S, Yoshizaki T, Matsuda T, Katayama N, Matsumoto M, Takagi M, Momose K, Eguchi T, Morisawa T, Okada A. A rare case of pyogenic granuloma of the jejunum causing gastrointestinal bleeding. Clin J Gastroenterol 2020; 13:1125-1128. [PMID: 32734317 DOI: 10.1007/s12328-020-01187-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/16/2020] [Indexed: 11/29/2022]
Abstract
Pyogenic granulomas (PG) are lobular capillary hemangiomas mostly found in the mucous membranes of the skin and oral cavity, and rarely occur in the gastrointestinal tract. Here we describe a case of an 84-year-old patient with alcoholic cirrhosis who presented with persistent melena and progressive anemia. Endoscopy showed esophageal varices and he underwent endoscopic variceal ligation (EVL) with transient resolution of anemia. However, due to worsening anemia, he underwent capsule endoscopy that revealed a bleeding tumor in the small intestine. We performed double-balloon endoscopy and found a 7-mm polyp with a white coat located in the jejunum and resected it at a later date. Histological characteristics led to the diagnosis of PG, and the patient's melena and anemia subsequently improved.
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Affiliation(s)
- Seitaro Ikeoka
- Department of Gastroenterology and Hepatology, Osaka Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Kita-ku, Osaka, 530-0012, Japan
| | - Tetsuya Yoshizaki
- Department of Gastroenterology and Hepatology, Osaka Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Kita-ku, Osaka, 530-0012, Japan.
| | - Tatsuya Matsuda
- Department of Gastroenterology and Hepatology, Osaka Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Kita-ku, Osaka, 530-0012, Japan
| | - Norio Katayama
- Department of Gastroenterology and Hepatology, Osaka Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Kita-ku, Osaka, 530-0012, Japan
| | - Masanori Matsumoto
- Department of Gastroenterology and Hepatology, Osaka Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Kita-ku, Osaka, 530-0012, Japan
| | - Megumi Takagi
- Department of Gastroenterology and Hepatology, Osaka Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Kita-ku, Osaka, 530-0012, Japan
| | - Kenji Momose
- Department of Gastroenterology and Hepatology, Osaka Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Kita-ku, Osaka, 530-0012, Japan
| | - Takaaki Eguchi
- Department of Gastroenterology and Hepatology, Osaka Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Kita-ku, Osaka, 530-0012, Japan
| | - Toshiyuki Morisawa
- Department of Gastroenterology and Hepatology, Osaka Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Kita-ku, Osaka, 530-0012, Japan
| | - Akihiko Okada
- Department of Gastroenterology and Hepatology, Osaka Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Kita-ku, Osaka, 530-0012, Japan
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Hayashi Y, Hosoe N, Takabayashi K, Kamiya KJL, Mutaguchi M, Miyanaga R, Hirata K, Fukuhara S, Mikami Y, Sujino T, Masugi Y, Naganuma M, Ogata H, Kanai T. Clinical and Endoscopic Characteristics of Pyogenic Granuloma in the Small Intestine: A Case Series with Literature Review. Intern Med 2020; 59:501-505. [PMID: 31611535 PMCID: PMC7056362 DOI: 10.2169/internalmedicine.3745-19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
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.
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Affiliation(s)
- Yukie Hayashi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Naoki Hosoe
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Japan
| | - Kaoru Takabayashi
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Japan
| | - Kenji Jl Limpias Kamiya
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Makoto Mutaguchi
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Japan
| | - Ryoichi Miyanaga
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Kenro Hirata
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Seiichiro Fukuhara
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Japan
| | - Yohei Mikami
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Tomohisa Sujino
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Yohei Masugi
- Department of Pathology, Keio University School of Medicine, Japan
| | - Makoto Naganuma
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Haruhiko Ogata
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Japan
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Romero Mascarell C, García Pagán JC, Araujo IK, Llach J, González-Suárez B. Pyogenic granuloma in the jejunum successfully removed by single-balloon enteroscopy. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2017; 109:152-154. [PMID: 28196424 DOI: 10.17235/reed.2017.4153/2015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Pyogenic granuloma is a non-infectious and non-granulomatous lesion. Its location in the small bowel is very rare. We present a 46 year-old woman with a chronic liver disorder that had a severe chronic anemia with occult blood losses. Upper endoscopy and colonoscopy were normal. A small bowel capsule endoscopy showed a pyogenic granuloma in jejunum that was resected endoscopically with single balloon enteroscopy with no major complications. The patient recovered from anemia and six months latter capsule endoscopy did not show lesions.
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Affiliation(s)
| | | | - Isis Karina Araujo
- Endoscopy Unit. Gastroenterology Department. , Hospital Clinic, Barcelona
| | - Josep Llach
- Endoscopy Unit. Gastroenterology Department. , Hospital Clinic, Barcelona
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De María J, Curvale C, Guidi M, Hwang H, Matanó R. Pyogenic granuloma of the jejunum; diagnosis and treatment with double-balloon enteroscopy: A case report. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2017. [DOI: 10.1016/j.rgmxen.2016.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Gastrointestinal Pyogenic Granuloma (Lobular Capillary Hemangioma): An Underrecognized Entity Causing Iron Deficiency Anemia. Case Rep Gastrointest Med 2016; 2016:4398401. [PMID: 27403353 PMCID: PMC4925958 DOI: 10.1155/2016/4398401] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 05/19/2016] [Accepted: 05/22/2016] [Indexed: 11/17/2022] Open
Abstract
Pyogenic granuloma (PG), more accurately known as lobular capillary hemangioma, is a benign vascular tumor that usually occurs in the skin or oral mucosa. This lesion is rarely reported in the gastrointestinal tract but is known to bleed if not resected. We herein describe a case series with the clinical, endoscopic, and histologic findings of four cases of gastrointestinal PG at our institution. In addition, we provide a review of the literature and summation of all reported cases of PG specific to the gastrointestinal tract. Based on our experience, we suggest that the actual incidence of gastrointestinal PG may in fact be higher than reported because PG can be unrecognized or improperly diagnosed. It is important for the clinician to properly recognize this lesion as a source of anemia and its propensity to bleed during biopsy or resection.
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De María J, Curvale C, Guidi M, Hwang H, Matanó R. Pyogenic granuloma of the jejunum; diagnosis and treatment with double-balloon enteroscopy: A case report. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2016; 82:94-96. [PMID: 27161794 DOI: 10.1016/j.rgmx.2015.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 08/11/2015] [Accepted: 10/12/2015] [Indexed: 11/28/2022]
Affiliation(s)
- J De María
- Servicio de Gastroenterología, Hospital de Alta Complejidad en Red El Cruce «Dr. Néstor Carlos Kirchner», Florencio Varela, Buenos Aires, República Argentina
| | - C Curvale
- Servicio de Gastroenterología, Hospital de Alta Complejidad en Red El Cruce «Dr. Néstor Carlos Kirchner», Florencio Varela, Buenos Aires, República Argentina.
| | - M Guidi
- Servicio de Gastroenterología, Hospital de Alta Complejidad en Red El Cruce «Dr. Néstor Carlos Kirchner», Florencio Varela, Buenos Aires, República Argentina
| | - H Hwang
- Servicio de Gastroenterología, Hospital de Alta Complejidad en Red El Cruce «Dr. Néstor Carlos Kirchner», Florencio Varela, Buenos Aires, República Argentina
| | - R Matanó
- Servicio de Gastroenterología, Hospital de Alta Complejidad en Red El Cruce «Dr. Néstor Carlos Kirchner», Florencio Varela, Buenos Aires, República Argentina
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Misawa SI, Sakamoto H, Kurogochi A, Kirii Y, Nakamura S, Misawa T, Yoneda S, Hirano M, Owa O, Takagi H, Ota H. Rare cause of severe anemia due to pyogenic granuloma in the jejunum. BMC Gastroenterol 2015; 15:126. [PMID: 26444414 PMCID: PMC4596517 DOI: 10.1186/s12876-015-0355-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 09/22/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pyogenic granuloma (PG) is a polypoid lobular capillary hemangioma rarely observed in the gastrointestinal tract. Only a few cases in the small bowel have been described in the literature. CASE PRESENTATION A 58-year-old man had been suffering from general fatigue and severe anemia. Esophagogastroduodenoscopy and colonoscopy did not reveal any significant bleeding. Abdominal computer tomography revealed a hypervascular tumor in the small intestine. Oral double-balloon endoscopy (DBE) detected a polypoid lesion (2 cm in diameter) in the jejunum. We performed laparoscopic-assisted partial resection of the jejunum. The histological features of the tumor were consistent with PG. The patient's anemia gradually improved without the need for oral iron after surgery. CONCLUSION In this case report, we present a case of pyogenic granuloma in in the jejunum that was detected by DBE.
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Affiliation(s)
- Shun-Ichi Misawa
- Department of Surgery, Matsumoto City Hospital, 4417-180 Hata, Matsumoto, Nagano, 3901401, Japan.
| | - Hiroto Sakamoto
- Department of Surgery, Matsumoto City Hospital, 4417-180 Hata, Matsumoto, Nagano, 3901401, Japan.
| | - Akira Kurogochi
- Department of Surgery, Matsumoto City Hospital, 4417-180 Hata, Matsumoto, Nagano, 3901401, Japan.
| | - Yasushi Kirii
- Department of Surgery, Matsumoto City Hospital, 4417-180 Hata, Matsumoto, Nagano, 3901401, Japan.
| | - Shinichiro Nakamura
- Department of Gastroenterology, Matsumoto City Hospital, 4417-180 Hata, Matsumoto, Nagano, 3901401, Japan.
| | - Tomoko Misawa
- Department of Gastroenterology, Matsumoto City Hospital, 4417-180 Hata, Matsumoto, Nagano, 3901401, Japan.
| | - Suguru Yoneda
- Department of Gastroenterology, Matsumoto City Hospital, 4417-180 Hata, Matsumoto, Nagano, 3901401, Japan.
| | - Mari Hirano
- Department of Gastroenterology, Matsumoto City Hospital, 4417-180 Hata, Matsumoto, Nagano, 3901401, Japan.
| | - Osamu Owa
- Department of Gastroenterology, Matsumoto City Hospital, 4417-180 Hata, Matsumoto, Nagano, 3901401, Japan.
| | - Hiroyuki Takagi
- Department of Surgery, Matsumoto City Hospital, 4417-180 Hata, Matsumoto, Nagano, 3901401, Japan.
| | - Hiroyoshi Ota
- Department of Biomedical Laboratory Sciences, Shinshu University, School of Medicine, 3-1-1 Asahi, Matsumoto, 3908621, Nagano, Japan.
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Abstract
A 53-year-old man with metastatic melanoma, in remission, presented with an 8-week history of melena and anemia. Initial investigations including upper and lower gastrointestinal endoscopy, capsule endoscopy, and Tc-labeled red blood cell scan did not reveal a source of bleeding. Given the concern over melanoma recurrence, F-FDG PET/CT was performed that demonstrated a focus of intense uptake in the small bowel. Uncomplicated surgical resection of the segment of jejunum containing the lesion was performed, after which the patient reported no further gastrointestinal bleeding. Histopathological assessment of the lesion was consistent with pyogenic granuloma.
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Obscure gastrointestinal bleeding: resection of a pyogenic granuloma of the ileum via double-balloon enteroscopy. Clin J Gastroenterol 2015; 7:397-401. [PMID: 26184018 DOI: 10.1007/s12328-014-0524-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Accepted: 08/06/2014] [Indexed: 10/24/2022]
Abstract
Pyogenic granulomas usually occur on the skin or oral mucosa; however, they rarely develop in the gastrointestinal tract, particularly in the ileum. We report the case of an 82-year-old female who experienced occasional bloody stools. Initially, no significant bleeding source could be identified via conventional endoscopy; however, repeat capsule endoscopy identified a bleeding polyp (8 mm) in the ileum. Therefore, we resected the polyp via double-balloon enteroscopy. Histopathological findings showed increased, lobulated, and enlarged capillaries and desquamated epithelium indicative of epithelial erosion. In addition, neutrophil-predominant inflammatory cell infiltrate and interstitial edema were observed in the intercapillary stroma. Immunohistochemical analysis showed positive staining for vascular endothelial cell markers. Previous reports have mentioned that pyogenic granulomas in the oral cavity were associated with the female hormonal receptor, vascular endothelial growth factor, and proliferative immune markers; however, no significant staining was observed in our patient. This is the first report discussing an association between pyogenic granulomas and these markers. Pyogenic granulomas in the ileum are rare and may cause fatal anemia. Pyogenic granulomas should be considered in the differential diagnosis of obscure gastrointestinal bleeding.
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Ohmiya N, Nakamura M, Tahara T, Nagasaka M, Nakagawa Y, Shibata T, Hirooka Y, Goto H, Hirata I. Management of small-bowel polyps at double-balloon enteroscopy. ANNALS OF TRANSLATIONAL MEDICINE 2014; 2:30. [PMID: 25333006 DOI: 10.3978/j.issn.2305-5839.2014.02.06] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 02/13/2014] [Indexed: 12/22/2022]
Abstract
Small bowel tumors (SBTs) are uncommon, insidious in presentation, and frequently represent a diagnostic challenge. The advent of video capsule endoscopy (VCE) and double-balloon endoscopy (DBE) is a significant breakthrough for visual diagnosis of SBTs throughout the small bowel. Contrast-enhanced computed tomography (CECT) and fluoroscopic enteroclysis had significantly lower diagnostic yields of tumors that were 10 mm or smaller in diameter, but VCE and DBE had high diagnostic yields regardless of tumor size. Regarding SBTs larger than 10 mm in diameter, CECT had a significantly lower diagnostic yield of epithelial tumors compared to subepithelial tumors, whereas fluoroscopic enteroclysis and DBE had high diagnostic yields regardless of the tumor type. VCE had a slightly lower diagnostic yield of subepithelial tumors (78%) compared to epithelial tumors. Therefore, a combined examination method by using CECT and VCE is useful for screening of SBTs. In case suspicious of stenosis, patency capsule should be performed to confirm passage before VCE. DBE is useful for further precise examination including biopsy and ultrasonography by using miniature probe, and enteroscopic treatment. After medical, enteroscopic, and surgical treatment, VCE is helpful for follow-up. DBE is safe and useful in resecting the SBTs deep within the small bowel without laparotomy. Indications of enteroscopic resection may be benign tumors regardless of epithelial or subepithelial type, localizing in the mucosal or submucosal layer, which are symptomatic at present or possibly symptomatic or transforming in the future. Malignant tumors localized in the mucosal layer may be indications although detecting at an early stage is challenging. In this review article, we describe management of SBTs/polyps by various modalities.
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Affiliation(s)
- Naoki Ohmiya
- 1 Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake, Japan ; 2 Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan ; 3 Department of Endoscopy, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Masanao Nakamura
- 1 Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake, Japan ; 2 Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan ; 3 Department of Endoscopy, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Tomomitsu Tahara
- 1 Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake, Japan ; 2 Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan ; 3 Department of Endoscopy, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Mitsuo Nagasaka
- 1 Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake, Japan ; 2 Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan ; 3 Department of Endoscopy, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Yoshihito Nakagawa
- 1 Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake, Japan ; 2 Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan ; 3 Department of Endoscopy, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Tomoyuki Shibata
- 1 Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake, Japan ; 2 Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan ; 3 Department of Endoscopy, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Yoshiki Hirooka
- 1 Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake, Japan ; 2 Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan ; 3 Department of Endoscopy, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Hidemi Goto
- 1 Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake, Japan ; 2 Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan ; 3 Department of Endoscopy, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Ichiro Hirata
- 1 Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake, Japan ; 2 Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan ; 3 Department of Endoscopy, Nagoya University Hospital, Nagoya, Aichi, Japan
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Brandel DW, Al-Hawary MM, Wasnik AP. Retroperitoneal lobular capillary hemangioma with synchronous ipsilateral renal cell carcinoma. ABDOMINAL IMAGING 2014; 39:1137-40. [PMID: 25237004 DOI: 10.1007/s00261-014-0142-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Lobular capillary hemangiomas (LCH) are acquired benign vascular tumors of skin and mucosal spaces of head and neck. Very few cases of LCH have been reported in the abdomen, predominantly occurring as mucosal polyps in the bowel. We present CT imaging features of solitary retroperitoneal LCH in a patient with synchronous ipsilateral renal cell carcinoma and review the available literature and imaging features in abdominal and extra-abdominal LCH. To our knowledge, there is no other case of retroperitoneal LCH available in the English literature.
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Affiliation(s)
- David W Brandel
- Division of Abdominal Imaging, Department of Radiology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA
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Kikuchi A, Sujino T, Yamaoka M, Yoneno K, Ohgo H, Takagi M, Morioka S, Hirooka E, Yamamoto K, Shinozuka N, Honma T, Kayano H, Nakamoto H, Imaeda H. Pyogenic granuloma of the ileum diagnosed by double-balloon enteroscopy. Intern Med 2014; 53:2057-9. [PMID: 25224187 DOI: 10.2169/internalmedicine.53.2468] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A pyogenic granuloma (PG) is a capillary hemangioma that usually occurs on the skin or in the oral cavity; it is rarely observed in the gastrointestinal tract. We herein describe a case of a 86-year-old woman who presented with anemia. Esophagogastroduodenoscopy and colonoscopy did not reveal any significant bleeding focus, but capsule endoscopy revealed a bleeding focus in the small intestine. We performed double-balloon enteroscopy and identified a 7-mm-diameter, reddish, subpedunculated, hemispheric polyp with a smooth surface in the small intestine, approximately 100 cm from the ileocecal valve. The polyp was surgically removed, and the histological findings were consistent with a diagnosis of PG.
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Affiliation(s)
- Azusa Kikuchi
- Department of General Internal Medicine, Saitama Medical University, Japan
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Rondonotti E, Sunada K, Yano T, Paggi S, Yamamoto H. Double-balloon endoscopy in clinical practice: where are we now? Dig Endosc 2012; 24:209-19. [PMID: 22725104 DOI: 10.1111/j.1443-1661.2012.01240.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Double-balloon endoscopy (DBE) was developed in 2000 for the diagnosis and treatment of small bowel diseases. Although use rates still differ between Eastern and Western countries, DBE quickly reached a broad global diffusion. Together with capsule endoscopy (CE), DBE represented 'a revolution' for the management of small bowel diseases because of its therapeutic capabilities. At present, the main indications for DBE in clinical practice are obscure gastrointestinal bleeding, Crohn's disease and familial polyposis. In the setting of obscure gastrointestinal bleeding, DBE seems to have similar diagnostic performances as capsule endoscopy, but it allows for a more definitive diagnosis and the treatment of identified lesions. The main contribution of DBE in the management of Crohn's disease patients is its therapeutic capabilities. Indeed, several recently published studies have suggested that endoscopic dilation of small bowel strictures can delay or, in the near future, could even replace surgical interventions. Also, for patients with familial polyposis syndromes, DBE can represent a viable alternative to small bowel surgery. The complication rate of DBE appears to be low; major complications, such as pancreatitis, bleeding and perforation, have been reported in approximately 1% of all diagnostic DBE whereas the complication rate for therapeutic procedures is about 5%.
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