Endoscopic Submucosal Dissection as a Therapeutic Option for Rectal Lesions in Patients with Ulcerative Colitis

Abstract

Ulcerative colitis is a type of inflammatory bowel disease, characterized by chronic mucosal inflammation that begins distally at the level of the rectum and extends proximally continuously. It is considered a high-risk condition for the development of colorectal cancer; therefore, surveillance colonoscopy is mandatory. We present the case of an 80-year-old patient with a diagnosis of extensive ulcerative colitis of 35 years of evolution. In surveillance colonoscopy, a non-granular pseudo-depressed lateral growth lesion measuring 30 mm in diameter, located in the middle rectum. Whence, an endoscopic submucosal dissection was performed to remove the lesion. The procedure was completed without complications. Endoscopic submucosal dissection is an advanced endoscopic technique, which allows complete and bloc resection of lesions at risk of superficial submucosal invasion, even in those with a high probability of submucosal fibrosis.