A 58-year-old man had been suffering from general fatigue and severe anemia for several months.
His hemoglobin levels were 6.6 g/dl (normal range: 12–16 g/dl).
He had no medical history and did not take any medicine.
Esophagogastroduodenoscopy and colonoscopy did not reveal any significant bleeding.
Abdominal computer tomography revealed a 2-cm hypervascular tumor in the small intestine (Fig.1).
Oral DBE detected a 2-cm-diameter reddish, submucosal tumor-like lesion with surface ulceration in the jejunum, approximately 20 cm away from the Treitz ligament (Fig.2).
We did not perform biopsy because it can be difficult to stop bleeding in the case of hypervascular lesions.
Under the diagnosis of a small bowel tumor, gastrointestinal stromal tumor (GIST), malignant lymphoma, or cancer, we performed laparoscopic-assisted segmental resection of the jejunum with the dissection of lymph nodes.
Examination of the resected tumor showed that it measured 19 × 16 mm in diameter (Fig.3).
Histology revealed the proliferation of blood capillaries and granulation tissue, which was consistent with PG (Fig.4).
The patient was discharged on postoperative day 9 without complication and his anemia improved gradually without the need for oral iron after surgery.