Endoscopic submucosal dissection (ESD) in ulcerative colitis (UC) – a pocketful of challenges!

Abstract Text A 74 year-old woman with ulcerative colitis (UC) and history of caecal adenocarcinoma was referred for endoscopic resection of a 45mm lateral-spreading tumor (LST) (Paris 0-IIa-IIc, JNET 2A) at the splenic flexure, previously tattooed. ESD (endoscopic submucosal dissection) was performed by saline-immersion therapeutic endoscopy (SITE)-facilitated pocket-creation method (PCM). En bloc (histologically R0) resection of the lesion was confirmed. This case highlights the effectiveness of SITE-PCM-ESD in the context of challenging location, submucosal fat deposition and severe submucosal fibrosis.