1. 72/M patient has come to us with c/o increased stool frequency and bleeding per rectum for last few months with some wt loss. Recent CT Scan showed a possibility of mass in the rectum with nodes.

  2. Ileo-Colonoscopic findings are suggestive of active ulcerative colitis affecting the recto sigmoid up to around 5 cms from the anal verge with large sessile lesion.
  3. Rectal EUS was then performed with a radial echo endoscope, which revealed essentially mucosal lesion limited to the muscularis mucosa.
  4. EMR (endoscopic mucosal resection) was then carried out with saline adrenaline injection followed by resection with snare and cautery. Complete resection was ensured and haemostasis was secured.
  5. Resected specimen was retrieved and sent for HPE which was diagnosed as adenocarcinoma.
Large sessile lesion was seen in the rectum

1. Large sessile lesion was seen in the rectum

Rectal EUS showed mucosal lesion limited to the muscularis mucosa

2. Rectal EUS showed mucosal lesion limited to the muscularis mucosa

Saline adrenaline injected

3. Saline adrenaline injected

EMR performed with snare and cautery

4. EMR performed with snare and cautery

Resected specimen was retrieved

5. Resected specimen was retrieved

Complete resection was ensured and haemostasis was secured

6. Complete resection was ensured an aemostasis was secured