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Clinical Journal of Gastroenterology

, Volume 12, Issue 1, pp 34–37 | Cite as

Pyogenic granuloma of the ampulla of Vater: unexpected cause of gastrointestinal bleeding

  • Helena Moreira SilvaEmail author
  • Gisela Silva
  • Emília Costa
  • Rosa Lima
  • Fernando Pereira
Case Report
  • 42 Downloads

Abstract

We describe the case of a previously healthy 8-year-old girl presenting with a 1-year history of iron deficiency anemia. There was no report of hematemesis, abdominal pain or melena. Laboratory work-up excluded iron malabsorption as the underlying cause. Therefore, endoscopic evaluation was performed to exclude gastrointestinal blood loss, which revealed the presence of a 7 mm reddish lesion located within the ampulla of Vater. Capsule endoscopy excluded alternative diagnoses and concomitant lesions. Histopathological examination confirmed the diagnosis of pyogenic granuloma. The young age of the child and the benign nature of this lesion along with the absence of complications favored conservative management. Pyogenic granuloma is a benign vascular lesion that presents as a polypoid red mass. In the gastrointestinal tract, it is a rare condition and occurs more commonly in the elderly. The most common sites are the small intestine, esophagus, and colon, but they can occur throughout the entire gastrointestinal tract with a propensity to bleed that may cause iron deficiency anemia. In pediatric age patients, there are few reports of gastrointestinal pyogenic granulomas, most of which occur in the colon and rectum. Its identification and location in the ampulla of Vater is an exceptional finding.

Keywords

Ampulla of Vater Iron deficiency anemia Gastrointestinal bleeding Pyogenic granuloma 

Notes

Author contributions

HMS drafted the initial manuscript, critically reviewed the manuscript, and approved the final manuscript as submitted. GS, EC, FP and RL critically reviewed the manuscript and approved the final manuscript as submitted.

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Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  1. 1.Pediatric Gastroenterology UnitCentro Materno Infantil do Norte, Oporto Hospital CenterPortoPortugal
  2. 2.Pediatric Hematology UnitCentro Materno Infantil do Norte, Oporto Hospital CenterPortoPortugal
  3. 3.Pediatric Gastroenterology UnitOporto Hospital CenterPortoPortugal

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